ackground ; In adult respiratory distress syndrome (ADRS) the pathologic supply
dependence of oxygen consumptionk, which provide the basis for 'best PEEP', is suggested,
but which is still in controversyl. And in acute pulmonary embolism little is known about
the relationship between oxygen trasport and oxygen consumption.
Methods ; To evaluate the relationship between oxygen transport and oxygen consumption
in ARDS and acute pulmonary embolism, experimental ARDS was induced in 7 mongrel dogs
with oleic acid and acute pulmonary embolism in 7 dogs with autologous blood clot. Then
hemodynamic and gas exchange parameters were measured with serial increment of PEEP.
Results ; In ARDS group, below the oxygen transport of 28 ml/min/kg, the change of
oxygen consumption was linearly related to the change of oxygen transport (r=0.55, p<0.05).
Oxygen extraction ratio didn't correlate with oxygen transport. In acute pulmonary embolism
group, below the oxygen transport of 29 ml/min/kg, change of oxygen consumption was
linearly relatred to change of oxygen transport (r=0.57, p<0.05). Oxygen extraction ratio
didn't correlate with oxygen transport. In ARDS group there was a significant correlation
between the change of oxygen transport and the change of mixed venous oxygen
tesion(r=0.79, p<0.05). In acute pulmonary embolism group there was a significant correlation
between the change of oxygen transport and change of mixed venous oxygen tenstion
(r=0.;83, p<0.05).
Conclustion : These data suggest that a linear relationship between oxygen consumption
and oxygen transport is not unique to ARDS. Mixed venous oxygen tension seems to be a
sensitive predictor of oxygen transport in both ADRS and acute pulmonary embolism.
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