Supra-physiological Oxygenation Literature Summaries

Danek, S. et al (1980) “The dependence of oxygen uptake on oxygen delivery in adult respiratory distress syndrome” Am Rev Respir Dis 122:387-395

  • some critically ill patients have an imbalance between oxygen supply and demand
    -> unmet metabolic demand despite normal ranges of oxygen delivery

Shoemaker, W.C., et al (1988) “Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients” Chest 94:1176-1186

  • increasing tissue supply of O2 may reduce mortality and morbidity
  • goal = attempt to find a benefit for ‘supranormal oxygen delivery’
  • n = small
  • supranormal O2 delivery VS standard care
    -> reduction in mortality reported
    -> heavily criticised study (not randomized, lack of similarity between treatment and control)

Gattinoni, L., et al (1995) “A trial of goal-oriented hemodynamic therapy in critically ill patients. SvO2 Collaborative Group.” N Engl J Med 333:1025-1032

  • n = 762
  • 3 groups: control, cardiac index and oxygen saturation
    -> no benefit shown

Hayes, M.A., et al (1994) “Elevation of systemic oxygen delivery in the treatment of critically ill patients.” N Engl J Med 330:1717-1722

-> increase morbidity and mortality


CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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