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Different dosages of dobutamine in septic shock patients : determining oxygen consumption with a metabolic monitor integrated in a ventilator
Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive ino...
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| Published in: | Intensive care medicine 2000-12, Vol.26 (12), p.1740-1746 |
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| container_end_page | 1746 |
| container_issue | 12 |
| container_start_page | 1740 |
| container_title | Intensive care medicine |
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| creator | SCHAFFARTZIK, Walter SANFT, Carsten SCHAEFER, Jürgen Heiner SPIES, Claudia |
| description | Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive inotropic support.
Prospective clinical study.
University Hospital, Surgical Intensive Care Unit (ICU).
Thirty patients suffering from sepsis.
DO2 was increased by dobutamine infusion, starting with an initial dosage of 5 microg x kg x min, increased to a maximum of 10 microg x kg x min.
Dobutamine infusion induced a dosage-related increase in DO2 (from 577 +/- 192 to 752 +/- 202 ml x min x m2, p < 0.01), which was associated with a statistically significant increase in VO2,IC (from 173 +/- 30 to 188 +/- 28 ml x min x m2, p < 0.01) and in VO2,Fick (from 140 +/- 25 to 156 +/- 24 ml x min x m2, p < 0.01). The comparison between VO2,IC and VO2,Fick revealed differences (bias and precision--33 +/- 32 ml x min x m2).
With a metabolic monitor integrated in a ventilator it was possible to carry out continuous monitoring of calorimetric data under clinical conditions. In contrast to previous studies using indirect calorimetry, this study showed a moderate correlation between VO2 and DO2 in septic patients using either method. The clinical relevance of this finding requires further investigation. Different factors (e. g. injectant temperature, pulmonary VO2) produced substantial differences between VO2,IC and VO2,Fick as previously shown. |
| doi_str_mv | 10.1007/s001340000635 |
| format | article |
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Prospective clinical study.
University Hospital, Surgical Intensive Care Unit (ICU).
Thirty patients suffering from sepsis.
DO2 was increased by dobutamine infusion, starting with an initial dosage of 5 microg x kg x min, increased to a maximum of 10 microg x kg x min.
Dobutamine infusion induced a dosage-related increase in DO2 (from 577 +/- 192 to 752 +/- 202 ml x min x m2, p < 0.01), which was associated with a statistically significant increase in VO2,IC (from 173 +/- 30 to 188 +/- 28 ml x min x m2, p < 0.01) and in VO2,Fick (from 140 +/- 25 to 156 +/- 24 ml x min x m2, p < 0.01). The comparison between VO2,IC and VO2,Fick revealed differences (bias and precision--33 +/- 32 ml x min x m2).
With a metabolic monitor integrated in a ventilator it was possible to carry out continuous monitoring of calorimetric data under clinical conditions. In contrast to previous studies using indirect calorimetry, this study showed a moderate correlation between VO2 and DO2 in septic patients using either method. The clinical relevance of this finding requires further investigation. Different factors (e. g. injectant temperature, pulmonary VO2) produced substantial differences between VO2,IC and VO2,Fick as previously shown.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s001340000635</identifier><identifier>PMID: 11271080</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bias ; Biological and medical sciences ; Blood Gas Analysis ; Calorimetry, Indirect - methods ; Cardiotonic Agents - administration & dosage ; Cardiotonic Agents - pharmacology ; Dobutamine - administration & dosage ; Dobutamine - pharmacology ; Dose-Response Relationship, Drug ; Drug Monitoring - methods ; Emergency and intensive care: infection, septic shock ; Hemodynamics - drug effects ; Humans ; Infusions, Intravenous ; Intensive care medicine ; Medical sciences ; Metabolism ; Middle Aged ; Oxygen Consumption - drug effects ; Parenteral nutrition ; Prospective Studies ; Respiration, Artificial - methods ; Sepsis ; Shock, Septic - drug therapy ; Shock, Septic - metabolism ; Shock, Septic - physiopathology ; Ventilators</subject><ispartof>Intensive care medicine, 2000-12, Vol.26 (12), p.1740-1746</ispartof><rights>2001 INIST-CNRS</rights><rights>Springer-Verlag 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-b578093769b13805905369552607bbf7beaac22dc161934fdf5c8c8d09d2decc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=818774$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11271080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SCHAFFARTZIK, Walter</creatorcontrib><creatorcontrib>SANFT, Carsten</creatorcontrib><creatorcontrib>SCHAEFER, Jürgen Heiner</creatorcontrib><creatorcontrib>SPIES, Claudia</creatorcontrib><title>Different dosages of dobutamine in septic shock patients : determining oxygen consumption with a metabolic monitor integrated in a ventilator</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive inotropic support.
Prospective clinical study.
University Hospital, Surgical Intensive Care Unit (ICU).
Thirty patients suffering from sepsis.
DO2 was increased by dobutamine infusion, starting with an initial dosage of 5 microg x kg x min, increased to a maximum of 10 microg x kg x min.
Dobutamine infusion induced a dosage-related increase in DO2 (from 577 +/- 192 to 752 +/- 202 ml x min x m2, p < 0.01), which was associated with a statistically significant increase in VO2,IC (from 173 +/- 30 to 188 +/- 28 ml x min x m2, p < 0.01) and in VO2,Fick (from 140 +/- 25 to 156 +/- 24 ml x min x m2, p < 0.01). The comparison between VO2,IC and VO2,Fick revealed differences (bias and precision--33 +/- 32 ml x min x m2).
With a metabolic monitor integrated in a ventilator it was possible to carry out continuous monitoring of calorimetric data under clinical conditions. In contrast to previous studies using indirect calorimetry, this study showed a moderate correlation between VO2 and DO2 in septic patients using either method. The clinical relevance of this finding requires further investigation. Different factors (e. g. injectant temperature, pulmonary VO2) produced substantial differences between VO2,IC and VO2,Fick as previously shown.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Bias</subject><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis</subject><subject>Calorimetry, Indirect - methods</subject><subject>Cardiotonic Agents - administration & dosage</subject><subject>Cardiotonic Agents - pharmacology</subject><subject>Dobutamine - administration & dosage</subject><subject>Dobutamine - pharmacology</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Monitoring - methods</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Oxygen Consumption - drug effects</subject><subject>Parenteral nutrition</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial - methods</subject><subject>Sepsis</subject><subject>Shock, Septic - drug therapy</subject><subject>Shock, Septic - metabolism</subject><subject>Shock, Septic - physiopathology</subject><subject>Ventilators</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNpd0U1vFSEUgGFiNPa2unRriCbdjfIxDOCuqW01aeJG1xMGDrfUGbgFprU_wv8sTW9slA0k58kbkoPQG0o-UELkx0II5T1pZ-DiGdrQnrOOMq6eow3hPev6oWcH6LCU6yblIOhLdEApk5QoskG_PwfvIUOs2KVitlBw8u05rdUsIQIOERfY1WBxuUr2J96ZGpou-BN2UCE3FOIWp1_3W4jYpljWpfEU8V2oV9jgBaqZ0twCS4qhptySFbbZVHAPdYNvWy_Mpo1eoRfezAVe7-8j9OP87Pvpl-7y28XX05PLznLFazcJqYjmctAT5YoITQQftBBsIHKavJzAGMuYs3SgmvfeeWGVVY5oxxxYy4_Q8WN3l9PNCqWOSygW5tlESGsZJRNCCyUafPcfvE5rju1vo9ZMSUaFbqh7RDanUjL4cZfDYvL9SMn4sKTxnyU1_3YfXacF3JPeb6WB93tgijWzzybaUP46RZWUPf8DLlma0w</recordid><startdate>20001201</startdate><enddate>20001201</enddate><creator>SCHAFFARTZIK, Walter</creator><creator>SANFT, Carsten</creator><creator>SCHAEFER, Jürgen Heiner</creator><creator>SPIES, Claudia</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20001201</creationdate><title>Different dosages of dobutamine in septic shock patients : determining oxygen consumption with a metabolic monitor integrated in a ventilator</title><author>SCHAFFARTZIK, Walter ; SANFT, Carsten ; SCHAEFER, Jürgen Heiner ; SPIES, Claudia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-b578093769b13805905369552607bbf7beaac22dc161934fdf5c8c8d09d2decc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Bias</topic><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis</topic><topic>Calorimetry, Indirect - methods</topic><topic>Cardiotonic Agents - administration & dosage</topic><topic>Cardiotonic Agents - pharmacology</topic><topic>Dobutamine - administration & dosage</topic><topic>Dobutamine - pharmacology</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Monitoring - methods</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Oxygen Consumption - drug effects</topic><topic>Parenteral nutrition</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial - methods</topic><topic>Sepsis</topic><topic>Shock, Septic - drug therapy</topic><topic>Shock, Septic - metabolism</topic><topic>Shock, Septic - physiopathology</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SCHAFFARTZIK, Walter</creatorcontrib><creatorcontrib>SANFT, Carsten</creatorcontrib><creatorcontrib>SCHAEFER, Jürgen Heiner</creatorcontrib><creatorcontrib>SPIES, Claudia</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SCHAFFARTZIK, Walter</au><au>SANFT, Carsten</au><au>SCHAEFER, Jürgen Heiner</au><au>SPIES, Claudia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Different dosages of dobutamine in septic shock patients : determining oxygen consumption with a metabolic monitor integrated in a ventilator</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>26</volume><issue>12</issue><spage>1740</spage><epage>1746</epage><pages>1740-1746</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><abstract>Oxygen consumption (VO2) obtained from respiratory gases by indirect calorimetry (VO2,IC) with a metabolic monitor integrated in a ventilator were to be compared to VO2 obtained by the Fick principle (VO2,Fick) in septic patients following an increase in oxygen delivery (DO2) induced by positive inotropic support.
Prospective clinical study.
University Hospital, Surgical Intensive Care Unit (ICU).
Thirty patients suffering from sepsis.
DO2 was increased by dobutamine infusion, starting with an initial dosage of 5 microg x kg x min, increased to a maximum of 10 microg x kg x min.
Dobutamine infusion induced a dosage-related increase in DO2 (from 577 +/- 192 to 752 +/- 202 ml x min x m2, p < 0.01), which was associated with a statistically significant increase in VO2,IC (from 173 +/- 30 to 188 +/- 28 ml x min x m2, p < 0.01) and in VO2,Fick (from 140 +/- 25 to 156 +/- 24 ml x min x m2, p < 0.01). The comparison between VO2,IC and VO2,Fick revealed differences (bias and precision--33 +/- 32 ml x min x m2).
With a metabolic monitor integrated in a ventilator it was possible to carry out continuous monitoring of calorimetric data under clinical conditions. In contrast to previous studies using indirect calorimetry, this study showed a moderate correlation between VO2 and DO2 in septic patients using either method. The clinical relevance of this finding requires further investigation. Different factors (e. g. injectant temperature, pulmonary VO2) produced substantial differences between VO2,IC and VO2,Fick as previously shown.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>11271080</pmid><doi>10.1007/s001340000635</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Bias Biological and medical sciences Blood Gas Analysis Calorimetry, Indirect - methods Cardiotonic Agents - administration & dosage Cardiotonic Agents - pharmacology Dobutamine - administration & dosage Dobutamine - pharmacology Dose-Response Relationship, Drug Drug Monitoring - methods Emergency and intensive care: infection, septic shock Hemodynamics - drug effects Humans Infusions, Intravenous Intensive care medicine Medical sciences Metabolism Middle Aged Oxygen Consumption - drug effects Parenteral nutrition Prospective Studies Respiration, Artificial - methods Sepsis Shock, Septic - drug therapy Shock, Septic - metabolism Shock, Septic - physiopathology Ventilators |
| title | Different dosages of dobutamine in septic shock patients : determining oxygen consumption with a metabolic monitor integrated in a ventilator |
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