文摘
秘密组织缺氧,尤其是内脏的地区,出现了重要的多器官衰竭(MOF)的发病机理。这次调查评估的影响(NAC)的防治作用的若干措施在10严重MOF患者组织氧合和内脏组织缺氧的证据(如一个病态低价值的建议(< 7.32)胃粘膜的pH值(φ))。后患者进行前瞻性随机,安慰剂对照,交叉设计。测量包括肺和全身血液动力学、心输出量通过热稀释法,动脉和混合静脉血气值,血乳酸浓度,分析全身耗氧量的过期的气体,通过张力测定法和φ。得到一套完整的测量之前和45分钟后注入NAC(150毫克。公斤的250毫升生理盐水),另外,之前和45分钟后注入同等体积的生理盐水。南汽增加心脏指数和泠体循环(p < 0.01)。然而,O2交付组织并没有增加,因为南汽后动脉氧含量下降(p < 0.01)。意味着O2提取或乳酸浓度NAC后没有改变,和φ略有下降(从7.11 + / - 0.21到7.07 + / - 0.21;p < 0.05)。 The infusion of saline did not modify any variable significantly. The O2 extraction fraction increased exponentially in those patients with reduced O2 transport to the tissues. These results argue against a beneficial effect of N-acetylcysteine upon tissue oxygenation in patients with severe multiple organ failure and evidence of splanchnic hypoxia. Furthermore, they suggest that the mechanisms controlling the extraction of oxygen by the peripheral tissues in these patients were not impaired.