Defective oxygen consumption in septic shock
Duff, J.H.; Groves, A.C.; McLean, A.P.; LaPointe, R.; MacLean, L.D.
Surgery Gynecology and Obstetrics 128(5): 1051-1060
1969
ISSN/ISBN: 0039-6087 PMID: 5813624 Document Number: 5155
In terminal or severe bacteremic shock, or both, in man and in endotoxin shock in the dog, decreased oxygen uptake is correlated with high arterial blood lactate. Hyperventilation as measured by a diminished arterial pCO2 did not correlate with total blood lactate. In the dog, inadequate blood flow accounts for the observed decrease in oxygen consumption and elevated arterial lactate. In man, a type of bacteremic shock occurs frequently without volume or cardiac deficits in which normal or increased flow rates are associated with elevated arterial blood lactate, decreased oxygen consumption, and decreased arteriovenous oxygen difference. Failure of oxygen utilization in this particularly lethal type of bacteremic shock appears to be due to profound cellular damage or arteriovenous shunting. Unlike bacteremic shock with hypovolemia or heart-failure, this type of shock has proved intractable to present methods of therapy.
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