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Oxygen consumption in critically ill children

Measurement of oxygen consumption (VO2) in the critically ill patient has become an important tool because of its prognostic value and therapeutic implications. If oxygen delivery does not match VO2, tissue hypoxia ensues followed by organ failure. It is well known that critically ill patients have increased VO2, however what has not been fully explored is whether different disease categories have varying degrees of VO2. The purpose of this study was to determine if VO2 differs between subgroups of critically ill children.

Methods

Ninety patients between the ages of 5 weeks and 16 years who were mechanically ventilated were included in this study. Patients were excluded if: air leak around the endotracheal tube was > 5%, FiO2 was > 0.6, or catecholamine infusion was required. VO2 was measured within the first 24 hours of admission to the pediatric intensive care unit. A Deltatrac metabolic monitor, which uses a paramagnetic oxygen analyzer, was used to measure VO2. Measurements were obtained over 20 min and standardized to body surface area. Patients were categorized into medical, surgical, trauma, sepsis or cardiac surgery subgroups. Mean VO2 in the medical subgroup was compared to the other subgroups.

Data was analyzed using one-way ANOVA and Bonferroni Multiple Comparisons test.

Results

There was a statistically significant difference in the mean VO2 between patients in the medical subgroup and patients in sepsis subgroup (P < 0.001), surgery subgroup (P < 0.01), and cardiac surgery subgroup (P < 0.001). There was no significant difference in the mean VO2 between patients in the medical subgroup and trauma subgroup.

Discussion

We have demonstrated that VO2 varies based on the category of critical illness. This finding is significant given the importance of optimizing and matching oxygen delivery to a patients' VO2.

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Sapiega, V., Havalad, S., Quaid, M. et al. Oxygen consumption in critically ill children. Crit Care 6, P210 (2002). https://doi.org/10.1186/cc1675

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Keywords

  • Oxygen Consumption
  • Body Surface Area
  • Endotracheal Tube
  • Critical Illness
  • Pediatric Intensive Care Unit