Oxygen supply and consumption in the adult respiratory distress syndrome

Supportive care of patients with the adult respiratory distress syndrome (ARDS) has evolved such that these patients die more frequently of multiple systems organ failure than of arterial hypoxemia itself. Many reports have suggested that ARDS may be associated with an impaired ability to extract oxygen from an otherwise adequate systemic delivery of oxygen; however, more recent studies have suggested that not all patients with ARDS or sepsis demonstrate this pathologic oxygen-supply dependency. Limitations in our current understanding of the nature, frequency, and significance of this abnormal oxygen-supply dependency have implications for the management of patients with critical illness.