Effect of cooling on oxygen consumption in febrile critically ill patients

C. A MANTHOUS; J. B HALL; D OLSON; M SINGH; WISAM CHATILA; A POHLMAN; R KUSHNER; G. A SCHMIDT; L. D. H WOOD

doi:10.1164/ajrccm.151.1.7812538

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Effect of cooling on oxygen consumption in febrile critically ill patients

Journal article

Peer reviewed

Effect of cooling on oxygen consumption in febrile critically ill patients

C. A MANTHOUS, J. B HALL, D OLSON, M SINGH, WISAM CHATILA, A POHLMAN, R KUSHNER, G. A SCHMIDT and L. D. H WOOD

American journal of respiratory and critical care medicine, Vol.151(1), pp.10-14

1995

DOI: 10.1164/ajrccm.151.1.7812538

PMID: 7812538

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Abstract

Hyperthermic critically ill patients are commonly cooled to reduce their oxygen consumption (VO2). However, no previous studies in febrile humans have measured VO2 during cooling. We cooled 12 febrile, critically ill, mechanically ventilated patients while measuring VO2 and CO2 production (VCO2) by analysis of inspired and expired gases. All patients were mechanically ventilated for hypoxemic, hypercapneic, or shock-related respiratory failure and had a mean APACHE II score of 22.4 +/- 7.7. As temperature was reduced from 39.4 +/- 0.8 to 37.0 +/- 0.5 degrees C, VO2 decreased from 359.0 +/- 65.0 to 295.1 +/- 57.3 ml/min (p < 0.01) and VCO2 decreased from 303.6 +/- 43.6 to 243.5 +/- 37.3 ml/min (p < 0.01). The respiratory quotient (RQ) did not change significantly, and calculated energy expenditure decreased from 2,481 +/- 426 to 1,990 +/- 33 kcal/day (p < 0.01). In 7 patients with right heart catheters, cardiac output decreased from 8.4 +/- 3.2 to 6.5 +/- 1.8 L/min (p < 0.01) as the oxygen extraction fraction also tended to decrease from a mean of 28.2 +/- 6.8 to 23.4 +/- 4.7% (p = 0.12) during cooling. Accordingly, cooling the febrile patient unloads the cardiorespiratory system and, in situations of limited oxygen delivery or hypoxemic respiratory failure, may thus facilitate resuscitation and minimize the potential for hypoxic tissue injury.

Biological and medical sciences

Intensive care medicine

Medical sciences

Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy

Emergency and intensive respiratory care

Details

Title: Subtitle: Effect of cooling on oxygen consumption in febrile critically ill patients
Creators: C. A MANTHOUS - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
J. B HALL - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
D OLSON - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
M SINGH - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
WISAM CHATILA - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
A POHLMAN - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
R KUSHNER - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
G. A SCHMIDT - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
L. D. H WOOD - Univ. Chicago, dep. medicine, sect. pulmonary critical care medicine, Chicago IL, United States
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.151(1), pp.10-14
Publisher: American Lung Association
DOI: 10.1164/ajrccm.151.1.7812538
PMID: 7812538
ISSN: 1073-449X
eISSN: 1535-4970
Language: English
Date published: 1995
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094594402771

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