Key result
Evaluation of 453 patients with acute myocardial infarction revealed an early down-regulation in oxygen demand linked to a decrease in oxygen supply.
In patients with acute myocardial infarction, there appears to be an early down-regulation in oxygen demand linked to decreased oxygen supply that is not necessarily associated with lactic acidosis.
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Challenges assumption of lactic acidosis in early acute MI; hypothesis-generating for adaptive mechanisms pending prospective validation.
The high mortality rate of cardiogenic shock in acute myocardial infarction (AMI) implies that debate over the correct haemodynamic management is still unresolved. The purpose of this review is to re-evaluate the reciprocal relationships between oxygen-related variables and response to treatment in a large number of patients with AMI. A MEDLINE search of reports published between 1970 and 2008 was performed. Twelve clinical reports including 453 patients with AMI and 989 sets of oxygen delivery and oxygen consumption expressed in ml min⁻¹ m⁻² and oxygen extraction ratio were selected. While processing this data, we found an early down-regulation in oxygen demand linked to a decrease in oxygen supply. This mechanism is also supported in some studies by a critically low oxygen uptake that was not associated with lactic acidosis.
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Turrión et al. (2010) conducted a review in acute myocardial infarction (n=453). Oxygen delivery and oxygen consumption was evaluated on Reciprocal relationships between oxygen-related variables. Evaluation of 453 patients with acute myocardial infarction revealed an early down-regulation in oxygen demand linked to a decrease in oxygen supply.
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