Characteristics of oxygen metabolism in 32 burn patient s with sepsis

doi:10.3969/j.issn.1009-4237.2001.01.006

Abstract：Objective　To explore the characteristics of oxygen delivery, oxygen consumption and oxygen extraction ratio in burn patie nts with sepsis,and to analyze the relationship between the clinical prognosis a nd oxygen metabolism.Methods　Thirty-two burn patients with sep sis admitted to our Burn Institute from March 1993 to September 1998 were analyz ed. The Swan-Ganz catheter was inserted for monitoring hemodynamics.According t o the arterial and venous partial pressure of oxygen, oxygen saturation and hem oglobin,the oxygen delivery, amount of oxygen consumption and oxygen extraction ratio were calculated.Results　The increases in oxygen delivery, amount of oxygen consumption and oxygen extraction ratio were observed when the sepsis emerged.They were gradually restored as the conditions of the patients b ecame stable, but still higher than the normal throughout the course of the obse rvation. However, when the patients developed MODS，the amount of oxygen consump tion and oxygen extraction ratio were lower than those in the patients without M ODS despite an increase in DO2, showing a different pattern of dependency of VO2 to DO2, and severe acidosis was manifested. Oxygen delivery, amount of oxygen consumption and oxygen extraction ratio at the terminal stage o f MODS subsequent to sepsis were obviously lower than those of the survivors.Conclusion　Hypermetabolism is one of the clinical manifestations i n patients with sepsis, therefore, to ensure an ample oxygen delivery,reduce amo unt of oxygen consumption and improve tissue oxygen extraction ratio should be t he importance measures to avoid tissue damage.