Fellowship Award

Oxygen Consumption Plateauing: A Better Method of Achieving Optimum Perfusion

The Ohio State University, Columbus, Ohio 43210

^* Address inquiries to J. P. Mandl, Medex, Inc., 4490 Edgewyn Ave., Hilliard, Ohio 43026.

Abstract

A method of conducting perfusion, by which the patient’s oxygen consumption (V̇O₂) is always being maximized, is presented. The endpoint of good perfusion is argued to occur when V̇O₂ plateaus despite further increases in cardiac index, haemoglobin concentration, arterial oxygen delivery, or pharmacological intervention. Thus, this method quickly assesses the patient’s varying oxygen demands, reduces metabolic acidosis, and enhances oxygen distribution.

Determination of V̇O₂ was done with in-line oxygen sensors (Critikon) and a handheld programmable calculator (Texas Instruments Model 59). No nomograms or tables are necessary and the time required is less than 80 seconds.

Exemplary cases demonstrate the value, cost effectiveness, and simplicity of the V̇O₂ plateauing method. The dependence upon conventionally used perfusion parameters such as venous saturations, flows, pressures, and urinary output are refuted.