scholarly journals THE OXYGEN CONTENT OF THE BLOOD IN LOBAR PNEUMONIA

1913 ◽  
Vol 18 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Francis W. Peabody

In most cases of uncomplicated lobar pneumonia the decrease of respiratory surface is completely compensated for, and the oxygen content of the blood is within normal limits. Occasional cases of uncomplicated pneumonia have an oxygen content of the venous blood which is below normal. In the two cases reported here, this was associated with a carbon dioxide content of the blood which was higher than normally, and the condition was apparently due to an interference with the respiratory exchange of gases. In the terminal stage of the fatal cases of pneumonia in which death does not occur with great suddenness, there is often a progressive diminution in the oxygen content of the blood. Synchronous with this is a progressive decrease in the oxygen-combining capacity of the blood. These changes are usually seen in patients in whom an intense bacteremia has developed and are analogous to those found in the arterial blood of infected rabbits, and to those resulting from the growth of the pneumococcus in blood in vitro. In all three conditions there is probably a change of oxyhemoglobin to methemoglobin. This change of the hemoglobin molecule, so that it no longer takes up and gives off oxygen readily, is probably a factor in the immediate cause of death in many cases of pneumonia.

1919 ◽  
Vol 30 (3) ◽  
pp. 241-257 ◽  
Author(s):  
George A. Harrop

1. The oxygen content of venous and of arterial blood from fifteen essentially normal individuals at rest in bed has been determined. 2. The percentage saturation of the arterial blood has varied between 100 and 94.3. The average is 95.5 per cent. 3. The oxygen consumption has varied between 2.6 and 8.3 volumes per cent. 4. The oxygen content and the percentage saturation of arterial blood taken at close intervals from three different peripheral arteries of a normal individual have shown values agreeing within the limits of error. Analyses of the blood gases of a normal individual, at rest and after exercise, have shown a lowering of the percentage oxygen saturation of the arterial blood and a diminished carbon dioxide content after exercise. 5. In three persons with severe anemia the saturation of the arterial blood has not differed from the normal. Very low absolute values were found for the oxygen content of the venous blood, but the normal oxygen consumption has been maintained. 6. The carbon dioxide content of the arterial blood from ten normal individuals has varied between 54.7 and 44.6 volumes per cent. That of the venous blood has varied between 60.4 and 48.3 volumes per cent. 7. No deviations from the normal values for oxygen and carbon dioxide were found in venous and arterial blood from cardiac patients without arrhytiunias, well compensated, and at rest in bed. 8. A series of determinations has been made upon nine cardiac patients with varying degrees of decompensation. The percentage oxygen saturation of the arterial blood on admission was abnormally low in seven of these cases. With the return to compensation and with the clearing up of pulmonary symptoms, the percentage saturation of the arterial blood returned to normal in four of them. 9. In a case of long standing mitral endocarditis with auricular fibrillation it remained low over a period of I month of observation. 10. In a case of chronic myocarditis secondary to emphysema and chronic bronchitis, it remained low over the period of observation. 11. Normal values for the percentage saturation of the arterial blood were found in two individuals with decompensated aortic disease but without physical signs of extensive pulmonary involvement. 12. The oxygen consumption tended to be high in individuals with cardiac disease during the periods of marked decompensation and to be lower as compensation was regained. 13. The data presented indicate that at least in many circulatory diseases during decompensation, particularly when there are physical signs of pulmonary congestion, there is a disturbance of the pulmonary exchange, as indicated by the lowering of the percentage saturation of the arterial blood with oxygen.


1929 ◽  
Vol 6 (4) ◽  
pp. 340-349 ◽  
Author(s):  
ALFRED C. REDFIELD ◽  
ROBERT GOODKIND

1. The oxygen and carbon-dioxide content of the arterial and venous blood of the squid, Loligo pealei, have been measured. 2. Using a nomographic method of analysis it is shown that the reciprocal effects of oxygen and carbon dioxide upon the respiratory properties of squid haemocyanin account for one-third of the respiratory exchange. 3. The venous blood is estimated to be 0.13 pH unit more acid than the arterial blood. 4. Death from asphyxiation occurs when the oxygen and carbon-dioxide pressures are such that the arterial blood can combine with only 0.5 to 1.5 volumes per cent, oxygen. Carbon dioxide exerts no toxic effect except through its influence on the oxygenation of the blood. 5. The haemocyanin of the blood is of vital necessity to the squid, because the amount of oxygen which can be physically dissolved in blood is less than the amount which is necessary for the maintenance of life.


1912 ◽  
Vol 16 (5) ◽  
pp. 701-718 ◽  
Author(s):  
Francis W. Peabody

A diminution in the carbon dioxide content of the blood is a constant feature in pneumonia. Occasional cases, however, may fail to show low carbon dioxide. The carbon dioxide in the blood bears little definite relation to the severity of the disease, except that it tends to be lowest in severe cases and in the terminal stages of the disease. There is less deviation from the normal in short or mild cases. The diminution in the carbon dioxide in the blood bears no immediate relation to temperature, as it may persist for some days after the patient is afebrile. The diminution in carbon dioxide corresponds to the other evidences of metabolic changes in infection and, like them, may be even greater after than during the febrile period. The changes in the carbon dioxide content of the blood run parallel to the output of ammonia in the urine. The carbon dioxide appears to bear no relation to chlorine excretion. In two unusual cases the carbon dioxide content of the blood was normal or above normal. This was associated with a very low oxygen content of the venous blood.


Perfusion ◽  
2006 ◽  
Vol 21 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Frode Kristiansen ◽  
Jan Olav Høgetveit ◽  
Thore H Pedersen

This paper presents the clinical testing of a new capno-graph designed to measure the carbon dioxide tension at the oxygenator exhaust outlet in cardiopulmonary bypass (CPB). During CPB, there is a need for reliable, accurate and instant estimates of the arterial blood CO2 tension (PaCO2) in the patient. Currently, the standard practice for measuring PaCO2 involves the manual collection of intermittent blood samples, followed by a separate analysis performed by a blood gas analyser. Probes for inline blood gas measurement exist, but they are expensive and, thus, unsuitable for routine use. A well-known method is to measure PexCO2, ie, the partial pressure of CO2 in the exhaust gas output from the oxygenator and use this as an indirect estimate for PaCO2. Based on a commercially available CO2 sensor circuit board, a laminar flow capnograph was developed. A standard sample line with integrated water trap was connected to the oxygenator exhaust port. Fifty patients were divided into six different groups with respect to oxygenator type and temperature range. Both arterial and venous blood gas samples were drawn from the CPB circuit at various temperatures. Alfa-stat corrected pCO2 values were obtained by running a linear regression for each group based on the arterial temperature and then correcting the PexCO2 accordingly. The accuracy of the six groups was found to be (±SD): ±4.3, ±4.8, ±5.7, ±1.0, ±3.7 and ±2.1%. These results suggest that oxygenator exhaust capnography is a simple, inexpensive and reliable method of estimating the PaCO2 in both adult and pediatric patients at all relevant temperatures.


1956 ◽  
Vol 185 (3) ◽  
pp. 483-486 ◽  
Author(s):  
Shirley H. Brind ◽  
Joseph R. Bianchine ◽  
Matthew N. Levy

Changes in cardiac output, mean arterial blood pressure, hematocrit ratio, and arterial and venous oxygen content resulting from bilateral carotid occlusion were investigated. Cardiac output exhibited no significant alteration during endosinusal hypotension, and the systemic hypertension engendered was attributed to an increase in vasomotor tone. Arterial and venous oxygen content, as well as hematocrit ratio, increased significantly during the period of carotid occlusion. This increase was ascribed to splenic contraction evoked by carotid occlusion, since no comparable augmentation was observed when the splenic circulation was temporarily interrupted.


1928 ◽  
Vol 47 (4) ◽  
pp. 593-610 ◽  
Author(s):  
Hans Smetana

The results of these observations may be briefly summarized as follows: Feeding of hematoporphyrin to white mice over long periods of time produced no apparent changes in these animals and had no effect upon their sensitivity to light. Albino and slightly pigmented mice and rats injected with hematoporphyrin were protected from the rays of the sun by staining them a blue-black color with Verhoeff's hematoxylin. The dioxyphenylalanine (Dopa) reaction revealed no changes in the cutaneous pigment of animals injected with hematoporphyrin and exposed to sunlight, kept in the dark or diffused daylight. It was therefore assumed that the natural pigment of the skin plays only a physical rôle in protecting animals injected with hematoporphyrin from sunlight. Exposure to sunlight of only the intestine and mesentery of a cat under ether anesthesia, which had been injected with hematoporphyrin, was followed by death of the animal. Repeated injections into white mice of large amounts of blood from guinea pigs in hematoporphyrin shock failed to produce symptoms of hematoporphyrin shock. In a parabiosis experiment, one of a pair of white rats promptly developed characteristic symptoms and died when injected with hematoporphyrin and exposed to sunlight, while the other animal, which was protected from light, but whose circulation had been demonstrated to connect freely with that of its partner, showed no changes during the entire procedure. It has, therefore, been impossible, so far, to demonstrate any substance present in the blood of animals in hematoporphyrin shock which is capable of reproducing this condition in other animals when introduced into the circulation. Injection of hematoporphyrin followed by exposure of the entire animal to sunlight has been found to produce physiological changes in cats similar to those observed in traumatic shock. There promptly occurred a rapid fall of blood pressure to a very low level and marked lowering of body temperature. The venous blood was found to be poor in oxygen, rich in carbon dioxide and to show low carbon dioxide-combining power. The respiration, which first was accelerated, later on became deep and irregular. The reflexes and typical blood pressure responses to cutaneous and vagal stimulation could always be obtained until death. Marked diminution of oxygen and increase of carbon dioxide content were found to occur in mixtures of blood and hematoporphyrin exposed in vitro to sunlight. These changes in the blood, identical with those occurring in vivo during hematoporphyrin shock, support Gaffron's views regarding the effect produced by the combined action of hematoporphyrin and light, but do not further elucidate the nature of the manner in which such alterations take place. Unsuccessful attempts were made to produce, in both cats and dogs, physiological changes similar to those observed in hematoporphyrin shock by exposing only the blood flowing through a quartz glass cannula, connecting the femoral artery and vein, to strong arclight and sunlight. In another series of animals, which were first injected with hematoporphyrin, exposure of the circulating blood alone to arclight or sunlight did not produce hematoporphyrin shock, although the blood pressure did fall to an unusually low level in one instance. No changes were found to occur in the amount of non-protein nitrogen, sugar or creatinine of the blood of animals in hematoporphyrin shock.


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