TAILIEUCHUNG - Báo cáo y học: "Intramucosal–arterial PCO2 gap does reflect tissue dysoxia — authors’ response"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Intramucosal–arterial PCO2 gap does reflect tissue dysoxia — authors’ response. | Available online http content 7 3 245 Letter Intramucosal-arterial Pco2 gap does reflect tissue dysoxia -authors response Arnaldo Dubin1 and Elisa Estenssoro2 1 Principal Investigator Cátedra de Farmacologia Facultad de Ciencias Médicas Universidad Nacional de La Plata La Plata Argentina 2Medical Director Servicio de Terapia Intensiva Hospital Interzonal General de Agudos Gral. San Martin de La Plata La Plata Argentina Correpsondence Arnaldo Dubin adee@ Published online 31 March 2003 Critical Care 2003 7 245 DOI cc2180 This article is online at http content 7 3 245 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X The main criticism of Gutierrez and Turkan 1 to our recent paper 2 is the absence of anaerobic metabolism in the hypoxic hypoxia HH group as an explanation for lack of increase in intramucosal-arterial Pco2 gradient APco2 . Despite their elegant arguments we still believe that the animals in the IH group were in an anaerobic state. Our statement is supported by the following. The presence of oxygen supply dependence Although the reduction in oxygen transport was greater in ischaemic hypoxia IH there were comparable falls in systemic and intestinal oxygen consumption in HH. We agree with Gutierrez and Turkan that oxygen supply dependence is not an infallible marker of anaerobic metabolism. However the occurrence of compensatory mechanisms to lower tissue metabolic rate and to decrease oxygen consumption Vo2 in response to hypoxaemia in an acute setting seems unlikely. Consequently we consider the fall in Vo2 as well as the metabolic response to represent evidence of anaerobic metabolism 3 . Metabolic acidosis As was pointed out by Gutierrez and Turkan 1 another parameter that may be used to determine the onset of anaerobiosis is the presence of increased H concentration in tissues and blood. Nevertheless we do not agree with their explanation of the lack of change in bicarbonate in HH. We .

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