Use of survivors' cardiorespiratory values as therapeutic goals in septic shock

摘要

The responses to therapy of 29 patients in septic shock are described. Patients received controlled plasma volume expansion followed by infusions of norepinephrine, dobutamine, and dopamine to achieve appropriate therapeutic goals. Increases in oxygen delivery (DO2) from 605 plusmn; 40 (SEM) to 843 plusmn; 27 ml/min plusmn; m2(p .001) were associated with increases in oxygen consumption (DO2) from 130 plusmn; 6.8 to 169 plusmn; 6.2 ml/min-m2(p .001). The overall hospital survival rate was 52percnt;. We suggest that the rational use of adrenergic agents and the achievement of appropriate physiologic end-points for therapy not only result in the reversal of hypotension, but also maintain or increase DO2and DO2, and may improve survival.