My paper 20 years later: effects of dobutamine on the VO2/DO2 relationship
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Oxygen uptake (VO2) is independent of oxygen delivery (DO2) over a wide range of values, because O2 extraction can readily adapt to changes in DO2. However, VO2 can become DO2-dependent in acute circulatory failure.
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.
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.
KeywordsOxygen uptake Oxygen delivery Oxygen extraction Microcirculation Lactate
Conflicts of interest
The authors declare they have no conflicts of interest to declare related to this article.
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