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Systemic Circulatory Function and Peripheral Oxygen Delivery in ALI and ARDS

  • Conference paper
Acute Lung Injury

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 30))

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Abstract

Advances in our understanding of the pathogenesis of acute respiratory distress syndrome (ARDS) and sepsis have shown the two to be intimately related. Al-though ARDS may develop from local lung injury, it is commonly part of the systemic inflammatory response to severe sepsis, and tissue damage in the lungs is the result of the same inflammatory mediators involved in other organ damage. Inflammatory injury to the lung microvessels is an early pathogenetic event in ARDS, and leukocytes in particular are implicated. The sequestration of neutrophils in the lungs and their activation by inflammatory mediators leads to the release of toxic substances such as lipid mediators and reactive oxygen metabolites. The result is an increase in pulmonary endothelial and epithelial permeability, and an accumulation of fluid in the pulmonary interstitial and alveolar spaces. This causes a reduced ventilated lung volume and impaired gas exchange. Hence, the same inflammatory response mechanisms take place in the lungs as in other organs leading to organ failure. Although cardiac output is normal or high and thus systemic oxygen delivery (D02) is well preserved, distant tissue hypoxia may thus arise. Most patients with ARDS, however, do not have tissue hypoxia, this only occurring if there is also acute circulatory failure. Poor tissue oxygenation may play a role in the development of organ failure which is often fatal. Mortality in ARDS patients is more often due to multiple organ failure than to refractory hypoxemia [1,2], and recognition of these abnormalities is therefore vitally important.

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References

  1. Montgomery BA, Stager MA, Car rico J, et al (1985) Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 132: 485 – 491

    PubMed  CAS  Google Scholar 

  2. Ferring M, Vincent JL (1997) Is outcome from ARDS related to the severity of respiratory failure? Eur Respir J (In Press)

    Google Scholar 

  3. Cain SM, Adams RP (1965) Appearance of excess lactate in anesthetized dogs during anemic and hypoxic hypoxia. Am J Physiol 209: 604 – 608

    PubMed  CAS  Google Scholar 

  4. Bakker J, Vincent JL (1991) The oxygen supply dependency phenomenon is associated with increased blood lactate levels. J Crit Care 6: 152 – 159

    Article  Google Scholar 

  5. Powers SR, Shah D, Ryon D, et al (1977) Hypertonic mannitol in the therapy of the acute respiratory distress syndrome. Ann Surg 185: 619 – 625

    Article  PubMed  Google Scholar 

  6. Rhodes GR, Newell JC, Shah D, et al (1978) Increased oxygen consumption accompanying increased oxygen delivery with hypertonic mannitol in adult respiratory distress syndrome. Surgery 84: 490 – 497

    PubMed  CAS  Google Scholar 

  7. Danek S, Lynch JP, Weg JG, Dantzker DR (1980) The dependence of oxygen uptake on oxygen delivery in the adult respiratory distress syndrome. Am Rev Respir Dis 122: 387 – 395

    PubMed  CAS  Google Scholar 

  8. Haupt MT, Gilbert EM, Carlson RW (1985) Fluid loading increases oxygen consumption in septic patients with lactic acidosis. Am Rev Respir Dis 131: 912 – 916

    PubMed  CAS  Google Scholar 

  9. Gilbert EM, Haupt MT, Mandanas RY, Huaringa AJ, Carlson RW (1986) The effect of fluid loading, blood transfusion and catecholamine infusion on oxygen delivery and consumption in patients with sepsis. Am Rev Respir Dis 134: 873 – 878

    PubMed  CAS  Google Scholar 

  10. Vincent JL, Roman A, De Backer D, Kahn RJ (1990) Oxygen uptake/supply dependency: Effects of short-term dobutamine infusion. Am Rev Respir Dis 142: 2 – 8

    PubMed  CAS  Google Scholar 

  11. Kruse JA, Haupt MT, Puri VK, Carlson RW (1990) Lactate levels as predictors of the relationship between oxygen delivery and consumption in ARDS. Chest 98: 959 – 962

    Article  PubMed  CAS  Google Scholar 

  12. Archie J (1981) Mathematic coupling of data: A common source of error. Ann Surg 193: 296 – 303

    Article  PubMed  Google Scholar 

  13. Ronco J J, Phang PT, Walley KR, Wiggs B, Fenwick JC, Russell JA (1991) Oxygen consumption is independent of changes in oxygen delivery in severe adult respiratory distress syndrome. Am Rev Respir Dis 143: 1267 – 1273

    PubMed  CAS  Google Scholar 

  14. Zhang H, Vincent JL (1993) Arteriovenous differences in PC02 and pH are good indicators of critical hypoperfusion. Am Rev Respir Dis 148: 867 – 871

    PubMed  CAS  Google Scholar 

  15. Nelson DP, Beyer C, Samsel RW, Wood LDH, Schumacker PT (1987) Pathological supply dependence of 02 uptake during bacteremia in dogs. J Appi Physiol 63: 1487 – 1492

    CAS  Google Scholar 

  16. Zhang H, Vincent JL (1993) Oxygen extraction is altered by endotoxin during tamponade induced stagnant hypoxia in the dog. Circ Shock 40: 168 – 176

    PubMed  CAS  Google Scholar 

  17. Nelson DP, Samsel RW, Wood LD, Schumacker PT (1988) Pathological supply dependency of systemic and intestinal 02 uptake during endotoxemia. J Appi Physiol 64: 2410 – 2419

    CAS  Google Scholar 

  18. Zhang H, Rogiers P, De Backer D, et al (1996) Regional arteriovenous differences in PC02 and pH are determinants of critical organ oxygen delivery during endotoxemia. Shock 5: 349 – 356

    Article  PubMed  CAS  Google Scholar 

  19. Demling RH, Knox J, Youn YK, LaLonde C (1992) Oxygen consumption early postburn becomes oxygen delivery dependent with the addition of smoke inhalation injury. J Trauma 32: 593 – 598

    Article  PubMed  CAS  Google Scholar 

  20. Dorinsky PM, Costello JL, Gadek JE (1988) Oxygen distribution and utilization after phorbol myrisate acetate-induced lung injury. Am Rev Respir Dis 138: 1454 – 1463

    PubMed  CAS  Google Scholar 

  21. Pepe PE, Culver BH (1985) Independently measured oxygen consumption during reduction of oxygen delivery by positive end-expiratory pressure. Am Rev Respir Dis 132: 788 – 792

    PubMed  CAS  Google Scholar 

  22. Crouser ED, Julian MW, Weisbrode SE, Dorinsky PM (1996) Acid aspiration results in ileal injury without altering ileal V02-D02 relationships. Am J Respir Crit Care Med 153: 1965 – 1971

    PubMed  CAS  Google Scholar 

  23. Komatsu T, Shibutani K, Okamoto K, et al (1987) Critical level of oxygen delivery after cardiopulmonary bypass. Crit Care Med 15: 194 – 197

    Article  PubMed  CAS  Google Scholar 

  24. Ronco JJ, Fenwick JC, Tweeddale MG, et al (1993) Identification of the critical oxygen delivery for anaerobic metabolism in critically ill septic and non-septic humans. JAMA 270: 1724 – 1730

    Article  PubMed  CAS  Google Scholar 

  25. Mohsenifar Z, Goldbach P, Tashkin DP, Campisi DJ (1983) Relationship between 02 delivery and 02 consumption in the adult respiratory distress syndrome. Chest 84: 267 – 271

    Article  PubMed  CAS  Google Scholar 

  26. Kaufman BS, Rackow EC, Falk JL (1984) The relationship between oxygen delivery and consumption during fluid resuscitation of hypovolemic and septic shock. Chest 85: 336 – 340

    Article  PubMed  CAS  Google Scholar 

  27. Kariman K, Burns SR (1985) Regulation of tissue oxygen extraction is disturbed in adult respiratory distress syndrome. Am Rev Respir Dis 132: 109 – 114

    PubMed  CAS  Google Scholar 

  28. Gutierrez G, Pohil RJ (1986) Oxygen consumption is linearly related to 02 supply in critically ill patients. J Crit Care 1: 45 – 53

    Article  Google Scholar 

  29. Wolf Y, Cotev S, Perei A, Manny J (1987) Dependence of oxygen consumption on cardiac output in sepsis. Crit Care Med 15: 198 – 203

    Article  PubMed  CAS  Google Scholar 

  30. Astiz ME, Rackow EC, Falk JL, Kaufman BS, Weil MH (1987) Oxygen delivery and consumption in patients with hyperdynamic septic shock. Crit Care Med 15: 26 – 28

    Article  PubMed  CAS  Google Scholar 

  31. Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 317: 397 – 403

    Article  PubMed  CAS  Google Scholar 

  32. Groeneveld AB J, Kester ADM, Nauta JJP (1987) Relation of arterial blood lactate to oxygen delivery and hemodynamic variables in human shock states. Circ Shock 22: 35 – 53

    PubMed  CAS  Google Scholar 

  33. Fenwick JC, Dodek PM, Ronco JJ, Phang PT, Wiggs B, Russell JA (1990) Increased concentrations of plasma lactate predict pathological dependence of oxygen consumption on oxygen delivery in patients with adult respiratory distress syndrome. J Crit Care 5: 81 – 87

    Article  Google Scholar 

  34. Dubin A, Estenssoro E, Silva C, et al (1990) Different oxygen transport patterns in patients with adult respiratory distress syndrome treated with positive end-expiratory pressure. J Crit Care 5: 101 – 107

    Article  Google Scholar 

  35. Pittet JF, Lacroix JS, Gunning K, Laverriere MC, Morel DR, Suter PM (1990) Prostacyclin but not phentolamine increases oxygen consumption and skin microvascular blood flow in patients with sepsis and respiratory failure. Chest 98: 1467 – 1472

    Article  PubMed  CAS  Google Scholar 

  36. Ronco J J, Montaner JSG, Fenwick JC, Ruedy J, Russell JA (1990) Pathologic dependence of oxygen consumption on oxygen delivery in acute respiratory failure secondary to AIDS-related Pneumocystis carinii pneumonia. Chest 98: 1463 – 1466

    Article  PubMed  CAS  Google Scholar 

  37. Lorente JA, Renes E, Gomez-Aguinaga MA, Landin L, de la Morena J, Liste D (1991) Oxygen delivery-dependent oxygen consumption in acute respiratory failure. Crit Care Med 19: 770 – 775

    Article  PubMed  CAS  Google Scholar 

  38. Silverman H, Turna P (1992) Gastric tonometry in patients with sepsis: Effects of dobutamine infusions and packed red blood cell transfusions. Chest 102: 184 – 188

    Article  PubMed  CAS  Google Scholar 

  39. Ranieri VM, Giuliani R, Eissa NT, et al (1992) Oxygen delivery-consumption relationship in septic adult respiratory distress syndrome patients: The effects of positive end-expiratory pressure. J Crit Care 7: 150 – 157

    Article  Google Scholar 

  40. Esen F, Telci L, Akpri K, Kesecioglu J, Denkel T, Pembeci K (1992) Oxygen uptake/supply dependency in human sepsis: Does it increase the risk of multisystem organ failure? In: Erdmann W, Bruley DF (eds) Oxygen transport to tissue XIV, Plenum Press, New York, pp 855 – 861

    Google Scholar 

  41. Ruokonen E, Takala J, Kari A, Saxen H, Mertsola J, Hansen EJ (1993) Regional blood flow and oxygen transport in septic shock. Crit Care Med 21: 1296 – 1303

    Article  PubMed  CAS  Google Scholar 

  42. Spec Marn A, Tos L, Kremzar B, Milic-Emili J, Ranieri VM (1993) Oxygen delivery-consumption relationship in adult respiratory distress syndrome patients: The effect of sepsis. J Crit Care 8: 43 – 50

    Article  PubMed  CAS  Google Scholar 

  43. Krachmann S, Lodato R, Morice R, Gutierrez G, Dantzker D (1994) Effects of dobutamine on oxygen transport and consumption in the adult respiratory distress syndrome. Intensive Care Med 20: 130 – 137

    Article  Google Scholar 

  44. De Backer D, Berré J, Zhang H, Vincent JL (1993) Relationship between oxygen uptake and oxygen delivery in septic patients: Effects of prostacyclin versus dobutamine. Crit Care Med 21: 1658 – 1664

    Article  PubMed  Google Scholar 

  45. De Backer D, Moraine JJ, Berré J, Kahn RJ, Vincent JL (1994) Effects of dobutamine on oxygen consumption in septic patients: Direct versus indirect determinations. Am J Respir Crit Care Med 150: 95 – 100

    PubMed  Google Scholar 

  46. Annat G, Viale JP, Percival C, Froment M, Motin J (1986) Oxygen delivery and uptake in the adult respiratory distress syndrome: Lack of relationship when measured independently in patients with normal blood lactate concentrations. Am Rev Respir Dis 133: 999 – 1001

    PubMed  CAS  Google Scholar 

  47. Ronco JJ, Fenwick JC, Wiggs BR, Phang PT, Russell JA, Tweeddale MG (1993) Oxygen consumption is independent of increases in oxygen delivery by dobutamine in septic patients who have normal or increased plasma lactate. Am Rev Respir Dis 147: 25 – 31

    PubMed  CAS  Google Scholar 

  48. Langeron O, Couture P, Mateo J, Riou B, Pansard JL, Coriat P (1996) Oxygen consumption and delivery relationship in brain-dead organ donors. Br J Anaesth 76: 783 – 789

    PubMed  CAS  Google Scholar 

  49. El Haddad P, De Backer D, Preiser JC, Kahn RJ, Vincent JL (1994) Increase in oxygen demand during weaning from mechanical ventilation after cardiovascular surgery. Intensive Care Med 20 (Suppl 2 ): S133 (Abst)

    Google Scholar 

  50. Villar J, Slutsky AS, Hew E, Aberman A (1990) Oxygen transport and oxygen consumption in critically ill patients. Chest 98: 687 – 692

    Article  PubMed  CAS  Google Scholar 

  51. Boyd O, Grounds M, Bennett D (1992) The dependency of oxygen consumption on oxygen delivery in critically ill postoperative patients is mimicked by variations in sedation. Chest 101: 1619 – 1624

    Article  PubMed  CAS  Google Scholar 

  52. Weissman C, Kemper M, Damask MC, Askanazi J, Hyman AI, Kinney JM (1984) Effect of routine intensive care interactions on metabolic rate. Chest 86: 815 – 818

    Article  PubMed  CAS  Google Scholar 

  53. Chioléro R, Flatt JP, Revelry JP, Jéquier E (1991) Effects of catecholamines on oxygen consumption and oxygen delivery in critically ill patients. Chest 100: 1676 – 1684

    Article  PubMed  Google Scholar 

  54. Green C, Frazer R, Underhill S, Maycock P, Fairhurst J, Campbell I (1992) Metabolic effects of dobutamine in normal man. Clin Science 82: 77 – 83

    CAS  Google Scholar 

  55. Bhatt SB, Hutchinson RC, Tomlinson B, Oh TE, Mak M (1992) Effect of dobutamine on oxygen supply and uptake in healthy volunteers. Br J Anaesth 69: 298 – 303

    Article  PubMed  CAS  Google Scholar 

  56. Van der Linden P, Gilbert E, Engelman E, Schmartz D, Vincent JL (1991) Effects of anesthetic agents on systemic critical 02 delivery. J Appi Physiol 71: 83 – 93

    Google Scholar 

  57. Kiiski R, Takala J, Kari A, Milic-Emili J (1992) Effect of tidal volume on gas exchange and oxygen transport in the adult respiratory distress syndrome. Am Rev Respir Dis 146: 1131 – 1135

    PubMed  CAS  Google Scholar 

  58. Teboul JL, Annane D, Thuillez C, Depret J, Bellissant E, Richard C (1992) Effects of cardiovascular drugs on oxygen consumption/oxygen delivery relationship in patients with congestive heart failure. Chest 101: 1582 – 1587

    Article  PubMed  CAS  Google Scholar 

  59. Teboul JL, Graini L, Boujdaria R, Berton C, Richard C (1993) Cardiac index vs oxygen derived parameters for rational use of dobutamine in patients with congestive heart failure. Chest 103: 81 – 85

    Article  PubMed  CAS  Google Scholar 

  60. Gutierrez G, Clark C, Brown SD, Price K, Ortiz L, Nelson C (1994) Effect of dobutamine on oxygen consumption and gastric mucosal pH in septic patients. Am J Respir Crit Care Med 150: 324 – 329

    PubMed  CAS  Google Scholar 

  61. Uusaro A, Hartikainen J, Parviainen M, Takala J (1995) Metabolic stress modifies the thermogenic effect of dobutamine in man. Crit Care Med 23: 674 – 680

    Article  PubMed  CAS  Google Scholar 

  62. Moreno LF, Stratton HH, Newell JC, Feustel PJ (1986) Mathematical coupling of data: Correction of a common error for linear calculations. J Appi Physiol 60: 335 – 343

    CAS  Google Scholar 

  63. Sasse SA, Chen PA, Berry RB, Sassoon CSH, Mahutte CK (1994) Variability of cardiac output over time in medical ICU patients. Crit Care Med 22: 225 – 232

    Article  PubMed  CAS  Google Scholar 

  64. Stratton HH, Feustel PJ, Newell JC (1987) Regression of calculated variables in the presence of shared measurement error. J Appi Physiol 62: 2083 – 2093

    CAS  Google Scholar 

  65. Forrester JS, Ganz W, Diamond G, McHugh T, Chonette DW, Swan JJ (1972) Thermodilution cardiac output determination with a single flow-directed catheter. Am Heart J 83: 306 – 311

    Article  PubMed  CAS  Google Scholar 

  66. Kubo SH, Burchenal JE, Cody RJ (1987) Comparison of direct Fick and thermodilution cardiac output techniques at high flow rates. Am J Cardiol 59: 384 – 386

    Article  PubMed  CAS  Google Scholar 

  67. Lipkin DP, Poole-Wilson PA (1985) Measurement of cardiac output during exercise by the thermodilution and direct Fick techniques in patients with chronic congestive heart failure. Am J Cardiol 56: 321 – 324

    Article  PubMed  CAS  Google Scholar 

  68. van Grondelle A, Ditchey RV, Groves BM, Wagner WW, Reeves JT (1983) Thermodilution method overestimates low cardiac output in humans. Am J Physiol 245: H690 – H692

    PubMed  Google Scholar 

  69. Vincent JL (1996) Determination of 02 delivery and consumption vs cardiac index vs oxygen extraction ratio. Crit Care Clinics 12: 995 – 1006

    Article  CAS  Google Scholar 

  70. Woodson RD, Wills RE, Lenfant C (1978) Effect of acute and established anemia on 02 transport at rest, submaximal and maximal work. J Appi Physiol 44: 36 – 43

    CAS  Google Scholar 

  71. Sutton JR, Reeves JT, Wagner PD, et al (1988) Operation Everest II: Oxygen transport during exercise at extreme simulated altitude. J Appi Physiol 64: 1309 – 1321

    CAS  Google Scholar 

  72. Silance PG, Simon C, Vincent JL (1994) The relation between cardiac index and oxygen extraction in acutely ill patients. Chest 105: 1190 – 1197

    Article  PubMed  CAS  Google Scholar 

  73. Light R (1988) Intrapulmonary oxygen consumption in experimental pneumococcal pneumonia. J Appi Physiol 64: 2490 – 2495

    CAS  Google Scholar 

  74. Levinson M, Groeger J, Miodownik S, Ray C, Brennan M (1987) Indirect calorimetry in the mechanically ventilated patient. Crit Care Med 15: 144 – 147

    Article  PubMed  CAS  Google Scholar 

  75. Chappell TR, Rubin LJ, Markham RV, Firth BG (1983) Independence of oxygen consumption and systemic oxygen transport in patients with either stable pulmonary hypertension or refractory left ventricular failure. Am Rev Respir Dis 128: 30 – 33

    PubMed  CAS  Google Scholar 

  76. Mohsenifar Z, Jasper AC, Koerner SK (1988) Relationship between oxygen uptake and oxygen delivery in patients with pulmonary hypertension. Am Rev Respir Dis 138: 69 – 73

    PubMed  CAS  Google Scholar 

  77. Bihari D, Smithies M, Pozniak A, Gimson A (1987) A comparison of direct and indirect measurements of oxygen delivery and consumption: The effects of prostacyclin in two human volunteers. Scand J Clin Lab Invest 47: 37 – 45

    Google Scholar 

  78. Albert RK, Schrijen F, Poincelot F (1986) Oxygen consumption and transport in stable patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 134: 678 – 682

    PubMed  CAS  Google Scholar 

  79. Iparraguirre HP, Finiger R, Garber VA, Quiroga E, Jorge MA (1988) Comparison between measured and Fick-derived values of hemodynamic and oxymetric variables in patients with acute myocardial infarction. Am J Med 85: 349 – 352

    Article  Google Scholar 

  80. Russell JA, Ronco JJ, Lockhat D, Beizberg A, Kiess M, Dodek PM (1990) Oxygen delivery and consumption and ventricular preload are greater in survivors than in non-survivors of the adult respiratory distress syndrome. Am Rev Respir Dis 141: 659 – 665

    PubMed  CAS  Google Scholar 

  81. Shoemaker WC, Appel PL, Kram HB,Waxman K,Lee TS (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high risk surgical patients. Chest 94: 1176 – 1186

    CAS  Google Scholar 

  82. Boyd O, Grounds M, Bennett ED (1993) A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high risk surgical patients. JAMA 270: 2699 – 2707

    Article  PubMed  CAS  Google Scholar 

  83. Tuchschmidt J, Fried J, Astiz M, Rackow E (1992) Elevation of cardiac output and oxygen delivery improves outcome in septic shock. Chest 102: 216 – 220

    Article  PubMed  CAS  Google Scholar 

  84. Fleming A, Bishop M, Shoemaker W, et al (1992) Prospective trial of supranormal values as goals of resuscitation in severe trauma. Arch Surg 127: 1175 – 1179

    PubMed  CAS  Google Scholar 

  85. Yu M, Levy MM, Smith P, Takiguchi SA, Miyasaki A, Myers SA (1993) Effect of maximizing oxygen delivery on morbidity and mortality rates in critically ill patients: A prospective, randomized, controlled study. Crit Care Med 21: 830 – 838

    Article  PubMed  CAS  Google Scholar 

  86. Hayes MA, Timmins AC, Yau EH, Palazzo M, Hinds CJ, Watson D (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330: 1717 – 1722

    Article  PubMed  CAS  Google Scholar 

  87. Gattinoni L, Brazzi L, Pelosi P, et al (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 333: 1025 – 1032

    Article  PubMed  CAS  Google Scholar 

  88. Bakker J, Vincent JL, Gris P, Leon M, Coffernils M, Kahn RJ (1992) Veno-arterial carbon dioxide gradient in human septic shock. Chest 101: 509 – 515

    Article  PubMed  CAS  Google Scholar 

  89. Friedman G, Berlot G, Kahn RJ, Vincent JL (1995) Combined measurements of blood lactate concentrations and gastric intramucosal pH in patients with severe sepsis. Crit Care Med 23: 1184 – 1193

    Article  PubMed  CAS  Google Scholar 

  90. Bakker J, Gris P, Coffernils M, Kahn RJ, Vincent JL (1996) Serial blood lactate levels can predict the development of multiple organ failure following septic shock. Am J Surg 171: 221 – 226

    Article  PubMed  CAS  Google Scholar 

  91. Van der Linden P, Gilbert E, Paques P, Simon C, Vincent JL (1993) Influence of hematocrit on tissue 02 extraction capabilities in anesthetized dogs during acute hemorrhage. Am J Physiol 264: H1942 – H1947

    PubMed  Google Scholar 

  92. Schlichtig R, Kramer DJ, Pinsky MR (1991) Flow redistribution during progressive hemorrhage is a determinant of critical 02 delivery. J Appi Physiol 70: 169 – 178

    CAS  Google Scholar 

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Authors
  1. J. L. Vincent
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  2. D. De Backer
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Editors and Affiliations

  1. Pulmonary and Critical Care, St. Paul Ramsey Medical Center, 640 Jackson Street, St. Paul, 55101, MN, USA

    John J. Marini

  2. Anaesthesia and Critical Care, Royal Brompton Hospital, Sydney Street, SW3 6NP, London, UK

    Timothy W. Evans

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Vincent, J.L., De Backer, D. (1998). Systemic Circulatory Function and Peripheral Oxygen Delivery in ALI and ARDS. In: Marini, J.J., Evans, T.W. (eds) Acute Lung Injury. Update in Intensive Care and Emergency Medicine, vol 30. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60733-2_11

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