The oxygen consumption/oxygen delivery curve in severe preeclampsia: Evidence for a fixed oxygen extraction state

Michael A. Belfort, John Anthony, George R. Saade, Nathan Wasserstrum, Richard Johanson, Steven Clark, Kenneth J. Moise

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

OBJECTIVE: Increased total body oxygen consumption requirements are usually met by increased oxygen delivery and increased oxygen extraction. In certain conditions (e.g., adult respiratory distress syndrome) the ability to increase oxygen extraction is lost, and any increase in oxygen consumption depends on increased oxygen delivery. The objective of this study was to investigate the oxygen delivery/oxygen consumption relationship in severe preeclampsia. STUDY DESIGN:. Thirty-two patients with severe preeclampsia (blood pressure > 160 110 mm Hg; 3 to 4+ proteinuria) were monitored with a pulmonary artery catheter. Baseline oxygen consumption and delivery in a group without volume expansion or pharmacologic vasodilatation were compared with those in a group who had received a magnesium sulfate infusion. RESULTS: Oxygen consumption, oxygen delivery, arterial-venous-oxygen difference, and the oxygen extraction ratio were low when compared to that for normal 32 to 38 week pregnancy. The oxygen extraction ratio, defined as the ratio of oxygen consumption to oxygen delivery, was abnormally low for pregnancy, especially considering the low oxygen delivery levels in these patients. Oxygen consumption was dependent on oxygen delivery over the entire range of values seen. CONCLUSIONS: Severe preeclampsia is associated with an abnormality of tissue oxygen extraction, as evidenced by a low and unresponsive oxygen extraction ratio. Oxygen consumption increases proportionately with increases in oxygen delivery without reaching an oxygen delivery-independent state. Even at high oxygen delivery levels the oxygen consumption in preeclamptic patients is still abnormally low for pregnancy.

Original languageEnglish (US)
Pages (from-to)1448-1455
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Volume169
Issue number6
DOIs
StatePublished - Dec 1993
Externally publishedYes

Keywords

  • Oxygen delivery
  • oxygen consumption
  • oxygen extraction ratio
  • preeclampsia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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