To examine the relation of oxygen delivery to uptake in normals, we have measured cardiac index, oxygen delivery and oxygen consumption directly and indirectly in two human volunteers before and during a prostacyclin (PGI2) infusion (5 ng/kg/min). We have also investigated the relation of direct and indirect measurements of delivery to consumption in two critically ill patients over a more prolonged study period of 24 hours. Overall, there were close correlations between both cardiac index measured by thermodilution with that calculated from the Fick equation (r = 0.97 p less than 0.001) and oxygen consumption measured directly by analysis of inspired gases (V O2) with that calculated by the reverse Fick method (OUI) (r = 0.95 p less than 0.001). Nevertheless, the limits of agreement between the two methods were wide (1.6 L/min.m2 for the cardiac index and 70.5 ml 02/min.m2 for oxygen consumption, 95% confidence limits). In the two human volunteers, PGI2 produced substantial increases in oxygen delivery but there was no change in oxygen consumption measured directly or indirectly; V O2 and OUI were unrelated and independent of oxygen delivery. However, in the two patients studied over 24 hours, there were close correlations between delivery and both V O2 (r = 0.93 p less than 0.001) and OUI (r = 0.94 p less than 0.001). These results suggest that the derivation of oxygen consumption by the reverse Fick method (OUI) is a reasonable substitute for direct measurements of V O2 but occasionally the absolute values so obtained may be somewhat different.(ABSTRACT TRUNCATED AT 250 WORDS)
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