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2017, Number 4

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Rev Mex Anest 2017; 40 (4)

Perioperative oxygen debit

Peña-Pérez CA

Language: Spanish
References: 65
Page: 273-279
PDF size: 212.82 Kb.


ABSTRACT

It is well established that a surgical intervention leads to the rapid activation of the stress response in a living organism. This response results in an increase in adrenocorticotropic hormone along with an excess of cortisol release, insulin resistance and a rise in catecholamine levels. In addition, the stress response is responsible for an increase in oxygen consumption. In the 1990’s, Shoemaker demonstrated that an oxygen debt starts to develop intraoperatively in high-risk surgical patients and that if these patients are unable to overcome this deficit during the first few hours postoperatively, an increase in morbidity and mortality was observed. He also observed that the incidence of organ failure and mortality were reduced when the oxygen deficit was rapidly compensated by optimizing haemodynamic variables, using a protocol aimed to reach the same haemodynamic values recorded in patients who survived. These data clearly demonstrated that some patients required haemodynamic support to overcome the surgical stress. Therefore, over the last two decades, several protocols have been developed to optimize haemodynamic parameters, with the aim of reducing tissue hypoperfusion and meeting the increased metabolic demands of the tissue as soon as possible.


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