Trauma

There has been much confusion concerning Vo2 following major trauma in man. Early work suggested that Vo2 was reduced in the first 24 to 48 h and later increased, the so-called 'ebb phase' followed by the 'flow phase'. More recently, the situation has been reappraised in more severely injured patients and it is now clear that, in the absence of hypothermia, Vo2 is maintained or even increased within the first 2 to 24 h. Subsequent oxygen transport patterns will depend on the rate of healing of injuries, the use of intubation and anesthesia, surgical procedures, and development of complications such as sepsis and acute respiratory distress syndrome. Even modest increases in OER and reductions in Sf^02 can be associated with poor outcome in trauma victims.

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