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Supranormal Elevation of Systemic Oxygen Delivery in Critically Ill Patients

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Book cover Reducing Mortality in Critically Ill Patients

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Abstract

Multiple organ dysfunction syndrome is the leading cause of mortality in intensive care units and is precipitated by tissue hypoperfusion. The optimization of oxygen delivery to supranormal levels by infusion of fluids, red blood cells and vasoactive drugs as needed has been adopted in an effort to avoid and reverse this tissue hypoxia and resultant organ damage. Both hemodynamic (cardiac index ≥ 4.5 L/min/m2) and oxygen transport (oxygen delivery ≥ 600mls/min/m2, oxygen consumption ≥ 170mls/min/m2) targets have been extensively investigated, however supranormal elevation of oxygen delivery does not improve overall outcome in critically ill patients. Furthermore, it is often difficult to achieve targets of increased oxygen consumption, with attempts to do this proving detrimental, as demonstrated in Hayes’ work. Early resuscitation, however, appears to be beneficial and a favorable response to hemodynamic optimization may predict survival.

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Author information

Authors and Affiliations

  1. Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK

    Kate C. Tatham & Michelle A. Hayes

  2. Department of Anaesthetics, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK

    C. Stephanie Cattlin

Authors
  1. Kate C. Tatham
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  2. C. Stephanie Cattlin
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  3. Michelle A. Hayes
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Corresponding author

Correspondence to Michelle A. Hayes .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Intensive care, IRCCS San Raffaele Scientifi c Institute, Milan, Milano, Italy

    Giovanni Landoni

  2. Department of Anesthesia and Intensive care, IRCCS San Raffaele Scientific Institute, Milan, Milano, Italy

    Marta Mucchetti

  3. San Raffaele Hospital, Milan, Italy

    Alberto Zangrillo

  4. Department of Intensive Care, Austin Hospital, Heidelberg, Vic. 3084, Australia

    Rinaldo Bellomo

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© 2015 Springer International Publishing Switzerland

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Tatham, K.C., Cattlin, C.S., Hayes, M.A. (2015). Supranormal Elevation of Systemic Oxygen Delivery in Critically Ill Patients. In: Landoni, G., Mucchetti, M., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-17515-7_12

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  • DOI: https://doi.org/10.1007/978-3-319-17515-7_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17514-0

  • Online ISBN: 978-3-319-17515-7

  • eBook Packages: MedicineMedicine (R0)

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