多器官衰竭患者的氧输送与氧消耗的关系

试图证实在多器官衰竭（ＭＯＦ）患者中存在氧输送（ＤＯ＿２）与氧消耗（ＶＯ＿２）关系中的氧摄取缺陷。１８例患者被分成ＭＯＦ组（ｎ＝１０）和非ＭＯＦ组（ｎ＝８）。在观察的初期（入院后６ｈ）和末期（拔除肺动脉导管之前）所测的氧动力学变化，两组之间无显著差异。研究终末期的病死率，ＭＯＦ组（８０．０％）显著高于非ＭＯＦ组（１２．５％），但出院病死率两组之间无显著差异。与非ＭＯＦ组相比，ＭＯＦ组有较高的氧耗病理性氧供依赖性的发生率。因此，研究的结论是单次氧动力学测量不能反映组织的氧合状况和疾病的危重程度；以出院病死率作为选择预后评价指标的标准可能是不合适的，氧耗的病理性氧供依赖性可能是ＭＯＦ的一个重要病埋生理机制。

Relationship between oxygen delivery and oxygen con-sumption in patients with multipl e organ failure

We attempted to identify oxygen extraction defectwhich might exist between oxygen delivery(DO_2)andoxygen consumption(VO_2)in patients with multiple or-gan failure (MOF). 18 critically ill patients were dividedinto MOF group(n = 10)and non-MOF group(n = 8).No significant difference in oxygen kinetic variables wasfound between groups in the initial( 6 hours after admis-sion)and teminal(before the removal of pulmonarycatheter)stages of the observation,Higher mortality atthe end of the study was found in MOF group as com-pared with non-MOF group ( 80.0%vs 12.5%)butthere was no sigmificant differpnce in mortality betweenthe two groups at the time of discharge, Higher incidenceof pathologic oxygen supply dependecy of oxygen con-siimption existed in MOF group as compared with non-MOF group. We conclude that a single kinetic lneasure-ment of oxygen couid not reflect the state of tissue oxy-genation and the severity of illness, It might be inade-quate to use the mortality op hospital discharge as an cri-terion for evaluating prognosis. Pathologic oxygen supplydependecy of oxygen consumption might be an importantpathophysiologic mechanism of MOF.