• Xinrong He, Fuhong Su, Keliang Xie, Fabio Silvio Taccone, Katia Donadello, and Jean-Louis Vincent.
• 1Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium. 2Department of Intensive Care, Sun Yat-sen University Cancer Center, Guangzhou, China. 3Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy.
• Crit. Care Med. 2017 Oct 1; 45 (10): e1060-e1067.

ObjectivesOptimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock.DesignRandomized animal study.SettingUniversity hospital animal research laboratory.SubjectsFourteen adult female sheep.InterventionsAfter induction of fecal peritonitis, sheep were randomized to ventilation with an FIO2 of 100% (n = 7) or an FIO2 adjusted to maintain PaO2 between 90 and 120 mm Hg (n = 7, control). All animals were fluid resuscitated and observed until death.Measurements And Main ResultsIn addition to hemodynamic measurements, we assessed the sublingual microcirculation, renal and cerebral microdialysis and microvascular perfusion, and brain tissue oxygen pressure. Hyperoxic animals initially had a higher mean arterial pressure than control animals. After onset of shock, hyperoxia blunted the decrease in stroke volume index observed in the control group. Hyperoxia was associated with a higher sublingual microcirculatory flow over time, with higher cerebral perfusion and brain tissue oxygen pressure and with a lower cerebral lactate-to-pyruvate ratio than in control animals. Hyperoxia was also associated with preserved renal microvascular perfusion, lower renal lactate-to-pyruvate ratio, and higher PaO2/FIO2 ratio.ConclusionsIn this acute peritonitis model, hyperoxia induced during resuscitation provided better hemodynamics and peripheral microvascular flow and better preserved cerebral metabolism, renal function, and gas exchange. These observations are reassuring with recent concerns about excessive oxygen therapy in acute diseases.

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