原创力文档red blood cell transfusion does not increase oxygen consumption in critically ill septic patients红细胞输血不会增加耗氧量在重症败血症的病人.pdfVIP
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red blood cell transfusion does not increase oxygen consumption in critically ill septic patients红细胞输血不会增加耗氧量在重症败血症的病人
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@einstein.br
Received: 26 March 2001 Critical Care 2001, 5:362-367
Revisions requested: 10 September 2001 © 2001 Fernandes et al., licensee BioMed Central Ltd
(Print ISSN 1364-8535; Online ISSN 1466-609X)
Revisions received: 4 October 2001
Accepted: 12 October 2001
Published: 1 November 2001
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: 25.5 ± 7.6) received an infusion of 1 unit of packed RBC over
1 h while sedated and paralyzed. The remaining five control patients (APACHE II: 24.3 ± 6.0) received
a 5% albumin solution (500 ml) over 1 h. Hemodynamic data, gastric tonometry and calo
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