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Extra resources for Applied Physiology in Intensive Care Medicine
Sustained tissue hypoxia is one of the most important cofactors in the pathophysiology of organ dysfunction . Therefore determining the adequacy of tissue oxygenation in critically ill patients is central to ascertain the health of the patient. Unfortunately, normal values in blood pressure, central venous pressure, heart rate, and blood gases do not rule out tissue hypoxia or imbalances between whole-body oxygen supply and demand . This discrepancy has led to increased interest in more direct indicators of adequacy of tissue oxygenation such as mixed and central venous oxygen saturations.
A decrease in SvO2 and ScvO2 represents an increased metabolic stress, because the O2 demands of the body are not completely met by DO2. The causes of a decreasing SvO2 are multiple and reflect the forces operative in Eqs. 5 and 6. That is, either DO2 does not increase in such a way to cover an increased VO2, or DO2 drops because of decrease in either arterial O2 content, cardiac output, or both. Importantly, the normal cardiovascular response of increasing VO2 is to increase O2 extraction and cardiac output.
Design, demography, pulse oximetry failure rate and overall complication rate. Anesthesiology 78:436–444 8. Spitall MJ (1993) Evaluation of pulse oximetry during cardiopulmonary resuscitation. Anaesthesia 48:701–703 9. Mower WR, Sachs C, Nicklin EL, Safa P, Baraff LJ (1996) A comparison of pulse oximetry and respiratory rate in patient screening. Respir Med 90:593– 599 10. Carruthers DM, Harrison BDW (1995) Arterial blood gas analysis or oxygen saturation in the assessment of acute asthma. Thorax 50:186–188 11.