title: My paper 20 years later: effects of dobutamine on the VO₂/DO₂ relationship.
abstract: BACKGROUND
  Oxygen uptake (VO₂) is independent of oxygen delivery (DO₂) over a wide range of values, because Ov extraction can readily adapt to changes in DO₂. However, VO₂ can become DO₂-dependent in acute circulatory failure.
  
  
  METHODS
  Various methods of evaluating the presence of VO₂/DO₂ dependency were conducted, but criticized because of potential problems with mathematical coupling of data. Some 20 years ago, we proposed using a dobutamine test and showed similar relationships using direct and indirect measurements. Since these studies on the systemic VO₂/DO₂ relationship, investigators have also explored regional alterations.
  
  
  CONCLUSIONS
  The relationship between VO₂ and DO₂ remains an important concept. Abnormal global VO₂/DO₂ dependency does not exist in stable, critically ill patients, but can exist in circulatory shock of all etiologies. It can also occur regionally in septic patients, and microcirculatory alterations may contribute. Patient management should be titrated individually with careful assessment to identify those who will benefit from increased DO₂.
authors.affiliation: Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium, jlvincen@ulb.ac.be.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
mesh_terms: D058665:Adrenergic beta-1 Receptor Agonists / Q000494:pharmacology*; D000818:Animals; D003422:Critical Care; D016638:Critical Illness; D004280:Dobutamine / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008833:Microcirculation / Q000187:drug effects; D010101:Oxygen Consumption / Q000187:drug effects*
chemical_list: D058665:Adrenergic beta-1 Receptor Agonists; D004280:Dobutamine