Email Alert RSS
Volume 13 Issue 6
Nov.  2022
Turn off MathJax
Article Contents
Article Navigation >  Medical Journal of Peking Union Medical College Hospital  > 2022  >  13(6): 915-920
DU Wei, WANG Xiaoting, LIU Dawei. In Shock Resuscitation, Blood Flow Should be Considered First, and Oxygen Flux Should be Optimized Second[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 915-920. doi: 10.12290/xhyxzz.2022-0441
Citation: DU Wei, WANG Xiaoting, LIU Dawei. In Shock Resuscitation, Blood Flow Should be Considered First, and Oxygen Flux Should be Optimized Second[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 915-920. doi: 10.12290/xhyxzz.2022-0441
shu

In Shock Resuscitation, Blood Flow Should be Considered First, and Oxygen Flux Should be Optimized Second

doi: 10.12290/xhyxzz.2022-0441

  • Department of Intensive Care Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds:

The Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences 2020-RW320-001

More Information
  • Corresponding author: LIU Dawei, E-mail: dwliu98@163.com
  • Received Date: 2022-08-10
  • Accepted Date: 2022-10-10
    • Available Online: 2022-10-26
  • Publish Date: 2022-11-30
    Abstract
  • An important milestone in human cognition of severe diseases began with a refined understanding of the hemodynamics of shock. After decades of development, the concept of hemodynamic therapy has become more perfect. The treatment of shock involves not only guided group therapy, but also bedside individualized strategies. The leading effect of blood flow has long been well understood, and the oxygen flux in the blood flow is the target index of hemodynamic resuscitation of shock. In this paper, we aim to further explore blood flow and blood oxygen flux, separate the influence factors of blood flow and oxygen flux, monitoring and recovery-guided treatment, and propose four subtypes based on blood flow and oxygen flux shock, with the hope of ushering in an era of more precise hemodynamic treatment for organ hemodynamic therapy.
    • FullText(HTML)
  • loading
    • References(20)
  • [1] Lamontagne F, Richards-Belle A, Thomas K, et al. Effect of Reduced Exposure to Vasopressors on 90-Day Mortality in Older Critically Ⅲ Patients With Vasodilatory Hypotension: A Randomized Clinical Trial[J]. JAMA, 2020, 323: 938-949. doi:  10.1001/jama.2020.0930
    [2] Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial[J]. JAMA, 2019, 21: 654-664.
    [3] Massey MJ, Larochelle E, Najarro G, et al. The microcirculation image quality score: development and preliminary evaluation of a proposed approach to grading quality of image acquisition for bedside videomicroscopy[J]. J Crit Care, 2013, 28: 913-917. doi:  10.1016/j.jcrc.2013.06.015
    [4] De Backer D, Donadello K, Sakr Y, et al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome[J]. Crit Care Med, 2013, 41: 791-799. doi:  10.1097/CCM.0b013e3182742e8b
    [5] Ait-Oufella H, Lemoinne S, Boelle PY, et al. Mottling score predicts survival in septic shock[J]. Intensive Care Med, 2011, 37: 801-807. doi:  10.1007/s00134-011-2163-y
    [6] Ospina-Tascon G, Neves AP, Occhipinti G, et al. Effects of fluids on microvascular perfusion in patients with severe sepsis[J]. Intensive Care Med, 2010, 36: 949-955. doi:  10.1007/s00134-010-1843-3
    [7] Edul VS, Ince C, Navarro N, et al. Dissociation between sublingual and gut microcirculation in the response to a fluid challenge in postoperative patients with abdominal sepsis[J]. Ann Intensive Care, 2014, 4: 39. doi:  10.1186/s13613-014-0039-3
    [8] Aldecoa C, Llau JV, Nuvials X, et al. Role of albumin in the preservation of endothelial glycocalyx integrity and the microcirculation: a review[J]. Ann Intensive Care, 2020, 10: 85. doi:  10.1186/s13613-020-00697-1
    [9] Nascente A, Freitas F, Bakker J, et al. Microcirculation improvement after short-term infusion of vasopressin in septic shock is dependent on noradrenaline[J]. Clinics (Sao Paulo), 2017, 72: 750-757. doi:  10.6061/clinics/2017(12)06
    [10] Du W, Liu D, Long Y, et al. The β-Blocker Esmolol Restores the Vascular Waterfall Phenomenon After Acute Endotoxemia[J]. Crit Care Med, 2017, 45: e1247-e1253. doi:  10.1097/CCM.0000000000002721
    [11] Modun D, Krnic M, Vukovic J, et al. Plasma nitrite concentration decreases after hyperoxia-induced oxidative stress in healthy humans[J]. Clin Physiol Funct Imaging, 2012, 32: 404-408. doi:  10.1111/j.1475-097X.2012.01133.x
    [12] Helmerhorst H, de Wilde R, Lee DH, et al. Hemodynamic effects of short-term hyperoxia after coronary artery bypass grafting[J]. Ann Intensive Care, 2017, 7: 20. doi:  10.1186/s13613-017-0246-9
    [13] Wei HS, Kang H, Rasheed ID, et al. Erythrocytes Are Oxygen-Sensing Regulators of the Cerebral Microcirculation[J]. Neuron, 2016, 91: 851-862. doi:  10.1016/j.neuron.2016.07.016
    [14] Uchimido R, Schmidt EP, Shapiro NI. The glycocalyx: a novel diagnostic and therapeutic target in sepsis[J]. Crit Care, 2019, 23: 16. doi:  10.1186/s13054-018-2292-6
    [15] Preau S, Vodovar D, Jung B, et al. Energetic dysfunction in sepsis: a narrative review[J]. Ann Intensive Care, 2021, 11: 104. doi:  10.1186/s13613-021-00893-7
    [16] Scheuzger J, Zehnder A, Meier V, et al. Sublingual microcirculation does not reflect red blood cell transfusion thresholds in the intensive care unit-a prospective observational study in the intensive care unit[J]. Crit Care, 2020, 24: 18. doi:  10.1186/s13054-020-2728-7
    [17] Bateman RM, Tokunaga C, Kareco T, et al. Myocardial hypoxia-inducible HIF-1alpha, VEGF, and GLUT1 gene expression is associated with microvascular and ICAM-1 heterogeneity during endotoxemia[J]. Am J Physiol Heart Circ Physiol, 2007, 293: H448-H456.
    [18] Ospina-Tascón GA, García Marin AF, Echeverri GJ, et al. Effects of dobutamine on intestinal microvascular blood flow heterogeneity and O(2) extraction during septic shock[J]. J Appl Physiol (1985), 2017, 122: 1406-1417. doi:  10.1152/japplphysiol.00886.2016
    [19] Kirkman MA, Smith M. Brain Oxygenation Monitoring[J]. Anesthesiol Clin, 2016, 34: 537-556. doi:  10.1016/j.anclin.2016.04.007
    [20] Römers LH, Bakker C, Dollée N, et al. Cutaneous Mitochondrial PO2, but Not Tissue Oxygen Saturation, Is an Early Indicator of the Physiologic Limit of Hemodilution in the Pig[J]. Anesthesiology, 2016, 125: 124-132. doi:  10.1097/ALN.0000000000001156
    • Relative Articles(0)
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (2387) PDF downloads(336) Cited by()
    Proportional views
    Related
    Links: National Health Commission of the People's Republic of China Chinese Academy of Medical Sciences(CAMS) AMLC Check CNKI Database CNKI Term Online Chinese General Practice
    Address：Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
    Tel：010-69154261/4262
    E - mail：medj@pumch.cn
    mjpumch@126.com
    Copyright of website：Editorial Office of Medical Journal of Peking Union Medical College Hospital

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return