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Correspondence
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Volume 331:1160-1162 October 27, 1994 Number 17
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Elevation of Systemic Oxygen Delivery in the Treatment of Critically Ill Patients

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 by Hayes, M. A.
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To the Editor: The study by Hayes et al. (June 16 issue)1 demonstrates that excessive doses of adrenergic agents (dobutamine alone or in combination with norepinephrine) may result in altered tissue function and increased mortality rates among critically ill patients. One should not infer from this study, however, that dobutamine should be avoided as a means of increasing oxygen delivery in some groups of critically ill patients or that attempts to optimize oxygen delivery in relation to the metabolic demands of the critically ill should be discouraged.

Two important issues must be considered. First, even though nearly half the patients . . . [Full Text of this Article]

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