Medicina
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Metabolic activity can be down-regulated throughout the reduction of mitochondrial population. Lowering O2 demand in cardiogenic, hemorrhagic and septic shock is here examined through clinical observations and trials. A decrease in the availability of O will be followed by reductions in mitochondrial population and, therefore, in a decrease in O2 demand. ⋯ Decoupling of mitochondrial oxidative phosphorylation occurs in both experimental models and in clinical septic shock. In critical patients this phenomenon may be detected by an inordinate increase in VO2 in response to a therapeutically increased DO. This hipermetabolic stage can be mistakenly interpreted as the repayment phase of an O2 debt.