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Intensive Care Medicine

, Volume 17, Issue 6, pp 325–332 | Cite as

Delivery dependent oxygen consumption in patients with septic shock: Daily variations, relationship with outcome and the sick-euthyroid syndrome

  • M. G. Palazzo
  • P. M. Suter
Originals

Abstract

Delivery dependent oxygen consumption (DDOC) is observed in patients with sepsis and vital organ dysfunction, and has been related to outcome. Similarly the sick-euthyroid syndrome is associated with a high mortality. We examined the daily variations of DDOC and its relation to hormonal changes, particularly those of the thyroid. In 22 patients, 14 with septic shock and 8 post-operative controls, oxygen delivery was increased by increasing cardiac output with vasodilation by phentolamine, during a total of 207 days. DDOC varied markedly between consecutive days in individual patients with sepsis, in both survivors and non-survivors. DDOC was related to severity of illness, assessed by APACHE II score (r=0.50,p=0.017), and plasma levels of triiodothyronine (T3),r=−0.49,p=0.011, and thyroxine (T4),r=−0.53,p=0.012. No correlation was observed between DDOC and outcome, nor blood levels of lactate, epinephrine, norepinephrine, dopamine or cortisol. In conclusion, we observed a marked disturbance of systemic oxygen uptake autoregulation in patients with septic shock which varied during the clinical course and was related to the sick-euthyroid syndrome.

Key words

Oxygen delivery Oxygen consumption Thyroid function Sick euthyroid syndrome Sepsis 

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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • M. G. Palazzo
    • 1
  • P. M. Suter
    • 1
  1. 1.Division of Surgical Intensive Care, Department of AnesthesiologyUniversity Hospital of GenevaGeneva 4Switzerland

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