FLUID LOADING INCREASES OXYGEN-CONSUMPTION IN SEPTIC PATIENTS WITH LACTIC-ACIDOSIS

Abstract

Patients with systemic sepsis and signs of circulatory failure were evaluated to determine if fluid loading was associated with increases in systemic oxygen delivery (.ovrhdot.DO2) and consumption (.ovrhdot.VO2). Fluid loading led to an increase in .ovrhdot.DO2 in 14 patients (70%). Patients who demonstrated increased .ovrhdot.DO2 with a corresponding increase in .ovrhdot.VO2 (group A, n = 8) had significantly higher (P < 0.05) initial blood lactate levels (4.9 .+-. 2.9 mmol/l, mean .+-. SD) than did patients without an increase in .ovrhdot.VO2 (group B, n = 6, 1.9 .+-. 1.0 mmol/l). A decrease in .ovrhdot.DO2 that was attributed to hemodilution was noted in the remaining 6 patients (group C). Group C exhibited elevated lactate levels (5.1 .+-. 2.4 mmol/l) and no significant changes in .ovrhdot.VO2. Lactic acidosis, a marker of anaerobic metabolism, predicts increases in .ovrhdot.VO2 in septic patients who respond to fluid loading with an increase in .ovrhdot.DO2.