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April 20, 1994

Critical Oxygen Delivery in Patients With Sepsis-Reply

Author Affiliations

Vancouver General Hospital Vancouver, British Columbia

JAMA. 1994;271(15):1158-1159. doi:10.1001/jama.1994.03510390028016

In Reply.  —Drs Bredle and Reinhart contend that our data do not refute the approach of increasing Do2 to supranormal levels in critically ill patients to increase Vo2 and hopefully improve outcome. They are right. Our study was not designed to test this hypothesis. However, our study and others have more clearly delineated the relationship between Do2 and Vo2 in humans and demonstrated that the rationale for increasing Do2 to supranormal levels is based on an incorrect understanding of this relationship.The technique of increasing Do2 to supranormal levels in critically ill patients has been based on the rationale that tissue hypoxia is present despite aggressive early resuscitation and return of adequate tissue perfusion according to traditional clinical and laboratory measurement. The presence of tissue hypoxia in these patients has been inferred from finding a correlation between Do2 and Vo2 when Do

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