How does oxygen delivery to tissue aid in treatment of sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Although initial aggressive resuscitation to maximize oxygen delivery improves outcome, manipulation of oxygen delivery to deliver supraphysiologic oxygen to tissues via blood transfusion, fluid boluses, or inotropic therapy once organ dysfunction has developed has not improved outcome in critically ill patients. Hayes et al reported a higher mortality in patients with sepsis who were maintained on high levels of oxygen delivery. [93] Thus, inotropic therapy is not recommended for increasing the cardiac index to supranormal levels. [11, 60]

In patients with septic shock, the inability to increase oxygen consumption and to decrease lactate levels most likely is a consequence of impaired oxygen extraction or inability to reverse anaerobic metabolism. Boosting oxygen delivery to supranormal levels does not reverse these pathophysiologic mechanisms after the development of organ injury.


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