tailieunhanh - Báo cáo y học: " Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients. | Critical Care December 2001 Vol 5 No 6 Fernandes et al. Research article Red blood cell transfusion does not increase oxygen consumption in critically ill septic patients Constantino J Fernandes Jr Nelson Akamine Fernando VC De Marco José AM de Souza Sofia Lagudis Elias Knobel Intensive Care Unit Hospital Israelita Albert Einstein São Paulo Brazil Correspondence Constantino Jose Fernandes Jr constantino@ Received 26 March 2001 Revisions requested 10 September 2001 Revisions received 4 October 2001 Accepted 12 October 2001 Published 1 November 2001 Critical Care 2001 5 362-367 2001 Fernandes et al. licensee BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Background Red blood cell RBC transfusion is commonly used to increase oxygen transport in patients with sepsis. However it does not consistently increase oxygen uptake at either the whole-body level as calculated by the Fick method or within individual organs as assessed by gastric intra-mucosal pH. Aim This study evaluates the hemodynamic and oxygen utilization effects of hemoglobin infusion on critically ill septic patients. Methods Fifteen septic patients undergoing mechanical ventilation whose hemoglobin was 10 g were eligible. Ten patients APACHE II received an infusion of 1 unit of packed RBC over 1 h while sedated and paralyzed. The remaining five control patients APACHE II received a 5 albumin solution 500 ml over 1 h. Hemodynamic data gastric tonometry and calorimetry were obtained prior to and immediately after RBC transfusion or 5 albumin infusion. Results Transfusion of RBC was associated with an improvement in left ventricular systolic work index to g min m2 P . In the control group there was no significant change in the left ventricular systolic work index to g min m2 . An increase in pulmonary vascular resistance index 203 58 to 238 49 dyne cm5 m2 P was also observed while no change was produced by .