Use of survivorsʼ cardiorespiratory values as therapeutic goals in septic shock

The responses to therapy of 29 patients in septic shock are described. Patients received controlled plasma volume expansion followed by infusions of norepinephrine, dobutamine, and dopamine to achieve appropriate therapeutic goals. Increases in oxygen delivery (DO2) from 605 ± 40 (SEM) to 843 ± 27 ml/min ± m (p < .001) were associated with increases in oxygen consumption (DO2) from 130 ± 6.8 to 169 ± 6.2 ml/min-m (p < .001). The overall hospital survival rate was 52%. We suggest that the rational use of adrenergic agents and the achievement of appropriate physiologic end-points for therapy not only result in the reversal of hypotension, but also maintain or increase DO2 and DO2, and may improve survival.