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Respiratory Quotient and Patterns of Substrate Utilization in Human Sepsis and Trauma
Author(s) -
Giovannini Ivo,
Boldrini Giuseppe,
Castagneto Marco,
Sganga Gabriele,
Nanni Giuseppe,
Pittiruti Mauro,
Castiglioni Giancarlo
Publication year - 1983
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607183007003226
Subject(s) - respiratory quotient , sepsis , lipogenesis , medicine , respiratory rate , cardiac index , respiratory failure , cardiology , cardiac output , endocrinology , heart rate , hemodynamics , blood pressure , metabolism
Three hundred measurements of indirect calorimetric and hemodynamic variables were performed in 99 critically ill septic and nonseptic surgical patients. Septics manifested, with respect to nonseptics, higher O 2 consumption, metabolic rate and cardiac index, and lower respiratory quotient in the presence of higher glucose infusion rates and glucose infusion rate/metabolic rate ratios. Among septics there was a group of more severely ill patients with signs of multiple organ failure who manifested a dissociated pattern characterized by a tendency to decreased O 2 consumption in the presence of increasing cardiac index and central venous O 2 partial pressure: they had higher respiratory quotients, with respect to the other septics, for a given glucose infusion rate/metabolic rate ratio. The lower mean respiratory quotient of septics indicates that they depend generally more than nonseptic trauma patients on fat as an energy substrate and confirms a previously obtained evidence of limited hepatic lipogenesis in sepsis. At the same time, however, it is suggested that fat utilization becomes impaired (and hepatic lipogenesis becomes prominent) in sepsis at a stage in which signs of impaired oxidative metabolism and major metabolic abnormalities also develop.