The Japanese Journal of Clinical Dialysis Vol.15 No.10(4-1)

Theme Multiple Organ Failure and Blood Purification Therapy
Title Circulatory failure
Publish Date 1999/09
Author Akiyoshi Hagiwara Department Traumatology and Critical Care Medicine, Matudo Municipal Hospital
Author Masanori Shibuya Department Traumatology and Critical Care Medicine, Matudo Municipal Hospital
Author Tetsuo Yukioka Department Traumatology and Critical Care Medicine, Kyorin University School of Medicine
[ Summary ] We illustrated circulatory failure in patients with MOF in relationship to oxygen delivery and consumption. Sepsis increases the oxygen upply to peripheral tissues and raises the critical point of oxygen delivery. Consequently, an insufficiency of oxygen delivery results in hypoxia and causes anaerobic metabolism. An increase in oxygen supply is caused by inflammatory reactions, due to several humoral mediators which are the main factors associated with MOF. the ultimate aim of treatment related to MOF is to improve hypoxia in tissues. The treatment procedures may be summarized as follows, first to increase oxygen delivery, and secondly to control inflammatory reactions due to humoral mediators. The former requires sufficient fluid resuscitation and medication using cardiotonic agents, which have the main effect on beta2-agonists. The latter requires dose removal of the humoral mediators. One useful method of removal is, continuous hemodiafiltration (CHDF).
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