Renal O2 consumption during progressive hemorrhage

1991 ◽  
Vol 70 (5) ◽  
pp. 1957-1962 ◽  
Author(s):  
R. Schlichtig ◽  
D. J. Kramer ◽  
J. R. Boston ◽  
M. R. Pinsky
Keyword(s):  
Extraction Ratio ◽  
Whole Body ◽  
O2 Consumption ◽  
Direct Proportion ◽  
Initial Value ◽  
Wide Range ◽  
Mammalian Tissues ◽  
O2 Extraction ◽  
O2 Delivery ◽  
The Relationship

Most mammalian tissues regulate O2 utilization such that O2 consumption (VO2) is relatively constant at O2 delivery (DO2) higher than a critical value (DO2c). We studied the relationship between VO2 and DO2 of kidney and whole body during graded progressive exsanguination. The relationship between whole body VO2 and DO2 was biphasic, and whole body VO2 decreased by 5.6 +/- 14.4% (P = NS) from the initial value to the value nearest whole body DO2c. Kidney DO2 decreased in direct proportion to whole body DO2 such that the average R2 value describing the linear regression of kidney DO2 vs. whole body DO2 was 0.94 +/- 0.02. The relationship between kidney, like whole body, VO2 and DO2 appeared biphasic; however, kidney VO2 decreased by 63.3 +/- 10.4% (P less than 0.0001) from the initial value to the value nearest kidney DO2c. Renal O2 extraction ratio was relatively constant over a wide range of kidney DO2, whereas whole body O2 extraction ratio increased progressively at all whole body DO2 values as whole body DO2 decreased. However, final values of O2 extraction ratio were indistinguishable for whole body (0.86 +/- 0.1) and kidney (0.86 +/- 0.06) (P = NS). We conclude that the pattern of kidney and whole body VO2 response to decreasing DO2 differs during hemorrhage, particularly in the range of DO2 normally associated with tissue wellness.

Systemic and diaphragmatic oxygen delivery-consumption relationships during hemorrhage

1994 ◽  
Vol 77 (2) ◽  
pp. 653-659 ◽  
Author(s):  
M. E. Ward ◽  
H. Chang ◽  
F. Erice ◽  
S. N. Hussain
Keyword(s):  
Work Of Breathing ◽  
Venous Blood ◽  
The Body ◽  
Extraction Ratio ◽  
Whole Body ◽  
Critical Threshold ◽  
Inferior Phrenic Artery ◽  
Left Hemidiaphragm ◽  
O2 Extraction ◽  
O2 Delivery

When tissue O2 delivery falls below a critical threshold, tissue O2 uptake (VO2) becomes limited. We compared critical O2 delivery and critical and maximum O2 extraction ratios of the resting and contracting left hemidiaphragm with those of nondiaphragmatic tissues in seven dogs. The left hemidiaphragm was perfused through the left inferior phrenic artery with blood from the left femoral artery. Phrenic venous blood was sampled through a catheter in the inferior phrenic vein. Systemic O2 delivery was reduced in stages by controlled hemorrhage. Left diaphragmatic VO2 during rest and during 3 min of continuous stimulation (3 Hz) of the left phrenic nerve and VO2 of the remaining nonleft hemidiaphragmatic tissues were measured at each stage. Critical diaphragmatic O2 delivery for the resting diaphragm averaged 0.8 +/- 0.16 ml.min-1.100 g-1 with a critical O2 extraction ratio of 65.5 +/- 6%. In the contracting diaphragm, they averaged 5.1 +/- 0.9 ml.min-1.100 g-1 and 81 +/- 5%, respectively. Whole body O2 delivery at which resting diaphragmatic VO2 became supply limited was similar to that for nondiaphragmatic tissues. By comparison, supply limitation of VO2 occurred at a higher systemic O2 delivery in the contracting diaphragm than in the rest of the body despite the increase in critical diaphragmatic extraction ratio. Thus, oxygenation of the isolated diaphragm does not appear to be preferentially preserved during generalized reductions in O2 delivery. These results suggest that, in diseases associated with increased work of breathing and decreased O2 delivery, the diaphragm may become metabolically impaired before limitation of VO2 is observed systemically.

Systemic and intestinal limits of O2 extraction in the dog

1987 ◽  
Vol 63 (1) ◽  
pp. 387-394 ◽  
Author(s):  
D. P. Nelson ◽  
C. E. King ◽  
S. L. Dodd ◽  
P. T. Schumacker ◽  
S. M. Cain
Keyword(s):  
Extraction Ratio ◽  
Whole Body ◽  
Systemic Delivery ◽  
O2 Uptake ◽  
Critical Limit ◽  
O2 Extraction ◽  
Isolated Segment ◽  
O2 Supply ◽  
O2 Delivery ◽  
Arterial Tone

When systemic delivery of O2 (QO2 = QT X CaO2, where QT is cardiac output and CaO2 is arterial O2 content) is reduced by bleeding, the systemic O2 extraction ratio [ER = (CaO2 - CVO2)/CaO2, where CVO2 is venous O2 content] increases until a critical limit is reached below which O2 uptake (VO2) becomes limited by O2 delivery. During hypovolemia, reflex increases in mesenteric arterial tone may preferentially reduce gut blood flow so that the onset of O2 supply dependence occurs in the gut before other regions. We compared the critical O2 delivery (QO2c) and critical extraction ratio (ERc) of whole body and an isolated segment (30–50 g) of small bowel in seven anesthetized paralyzed dogs ventilated with room air. Systemic QO2 was reduced in stages by controlled hemorrhage as arterial O2 content was maintained, and systemic and gut VO2 and QO2 were measured at each stage. Body QO2c was 7.9 +/- 1.9 ml X kg-1 X min-1 (ERc = 0.69 +/- 0.12), whereas gut O2 supply dependency occurred when gut QO2 was 34.3 +/- 11.3 ml X min-1 X kg gut wt-1 (ERc = 0.63 +/- 0.09). O2 supply dependency in the gut occurred at a higher systemic QO2 (9.7 +/- 2.7) than whole-body QO2c (P less than 0.05). The extraction ratio at the final stage (maximal ER) was less in the gut (0.80 +/- 0.05) than whole body (0.87 +/- 0.06). Thus during reductions in systemic QO2, gut VO2 was maintained by increases in gut extraction of O2.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatic oxygen and lactate extraction during stagnant hypoxia

1991 ◽  
Vol 70 (1) ◽  
pp. 186-193 ◽  
Author(s):  
R. W. Samsel ◽  
D. Cherqui ◽  
A. Pietrabissa ◽  
W. M. Sanders ◽  
M. Roncella ◽  
...  
Keyword(s):  
The Body ◽  
O2 Consumption ◽  
Extraction Capacity ◽  
Blood Flows ◽  
O2 Extraction ◽  
Lactate Uptake ◽  
O2 Supply ◽  
O2 Delivery ◽  
Relationship Of ◽  
The Relationship

As O2 delivery falls, tissues must extract increasing amounts of O2 from blood to maintain a normal O2 consumption. Below a critical delivery threshold, increases in O2 extraction cannot compensate for the falling delivery, and O2 uptake falls in a supply-dependent fashion. Numerous studies have identified a critical delivery in whole animals, but the regional contributions to the critical O2 delivery are less fully understood. In the present study, we explored the limits of O2 extraction in the isolated liver, seeking to determine 1) the normal relationship between O2 consumption and delivery in the liver and 2) the relationship of hepatic lactate extraction to the drop in hepatic O2 consumption at low O2 deliveries. To answer these questions, using support dogs as a source for oxygenated metabolically stable blood, we studied eight pump-perfused canine livers. By lowering the blood flow in a model of stagnant hypoxia, we explored the relationship between O2 consumption and delivery over the entire physiological range of O2 delivery. The critical O2 delivery was 28 +/- 5 (SD) ml.kg-1.min-1; the livers extracted 68 +/- 9% of the delivered O2 before reaching supply dependence. This suggests that the liver has an O2 extraction capacity quite similar to the body as a whole and not different from other tissues that have been isolated. At high blood flows, the livers extracted approximately 10% of the lactate delivered by the blood, but the arteriovenous lactate differences were small. At low blood flows, however, the livers changed from lactate consumption to production. The O2 delivery coinciding with the dropoff in lactate extraction did not differ significantly from the critical O2 delivery. We conclude that reductions in lactate uptake by the liver do not precede the transition to O2 supply dependence.

Analysis of oxygen delivery and uptake relationships in the Krogh tissue model

1989 ◽  
Vol 67 (3) ◽  
pp. 1234-1244 ◽  
Author(s):  
P. T. Schumacker ◽  
R. W. Samsel
Keyword(s):  
Blood Flow ◽  
Critical Point ◽  
Real Data ◽  
Whole Body ◽  
O2 Uptake ◽  
Highly Sensitive ◽  
O2 Extraction ◽  
O2 Supply ◽  
Experimental Findings ◽  
O2 Delivery

Normally, tissue O2 uptake (VO2) is set by metabolic activity rather than O2 delivery (QO2 = blood flow X arterial O2 content). However, when QO2 is reduced below a critical level, VO2 becomes limited by O2 supply. Experiments have shown that a similar critical QO2 exists, regardless of whether O2 supply is reduced by progressive anemia, hypoxemia, or reduction in blood flow. This appears inconsistent with the hypothesis that O2 supply limitation must occur by diffusion limitation, since very different mixed venous PO2 values have been seen at the critical point with hypoxic vs. anemic hypoxia. The present study sought to begin clarifying this paradox by studying the theoretical relationship between tissue O2 supply and uptake in the Krogh tissue cylinder model. Steady-state O2 uptake was computed as O2 delivery to tissue representative of whole body was gradually lowered by anemic, hypoxic, or stagnant hypoxia. As diffusion began to limit uptake, the fall in VO2 was computed numerically, yielding a relationship between QO2 and VO2 in both supply-independent and O2 supply-dependent regions. This analysis predicted a similar biphasic relationship between QO2 and VO2 and a linear fall in VO2 at O2 deliveries below a critical point for all three forms of hypoxia, as long as intercapillary distances were less than or equal to 80 microns. However, the analysis also predicted that O2 extraction at the critical point should exceed 90%, whereas real tissues typically extract only 65–75% at that point. When intercapillary distances were larger than approximately 80 microns, critical O2 extraction ratios in the range of 65–75% could be predicted, but the critical point became highly sensitive to the type of hypoxia imposed, contrary to experimental findings. Predicted gas exchange in accord with real data could only be simulated when a postulated 30% functional peripheral O2 shunt (arterial admixture) was combined with a tissue composed of Krogh cylinders with intercapillary distances of less than or equal to 80 microns. The unrealistic efficacy of tissue O2 extraction predicted by the Krogh model (in the absence of postulated shunt) may be a consequence of the assumed homogeneity of tissues, because real tissues exhibit many forms of heterogeneity among capillary units. Alternatively, the failure of the original Krogh model to fully predict tissue O2 supply dependency may arise from basic limitations in the assumptions of that model.

Gastrointestinal blood flow and oxygen consumption in awake newborn piglets: effect of feeding

1983 ◽  
Vol 245 (5) ◽  
pp. G697-G702 ◽  
Author(s):  
P. T. Nowicki ◽  
B. S. Stonestreet ◽  
N. B. Hansen ◽  
A. C. Yao ◽  
W. Oh
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
O2 Consumption ◽  
Gi Tract ◽  
Local Blood Flow ◽  
O2 Uptake ◽  
O2 Extraction ◽  
Gastrointestinal Blood Flow ◽  
O2 Delivery ◽  
Effect Of Feeding

Regional and total gastrointestinal (GI) blood flow, O2 delivery, and whole-gut O2 extraction and O2 consumption were measured before and 30, 60, and 120 min after feeding in nonanesthetized, awake 2-day-old piglets. Cardiac output and blood flow to kidneys, heart, brain, and liver were also determined. Blood flow was measured using the radiolabeled microsphere technique. In the preprandial condition, total GI blood flow was 106 +/- 9 ml X min-1 X 100 g-1, while O2 extraction was 17.2 +/- 0.9% and O2 consumption was 1.99 +/- 0.19 ml O2 X min-1 X 100 g-1. Thirty minutes after slow gavage feeding with 30 ml/kg artificial pig milk, O2 delivery to the GI tract and O2 extraction rose significantly (P less than 0.05) by 35 +/- 2 and 33 +/- 2%, respectively. The increase in O2 delivery was effected by a significant increase in GI blood flow, which was localized to the mucosal-submucosal layer of the small intestine. O2 uptake by the GI tract increased 72 +/- 4% 30 min after feeding. Cardiac output and blood flow to non-GI organs did not change significantly with feeding, whereas arterial hepatic blood flow decreased significantly 60 and 120 min after feeding. The piglet GI tract thus meets the oxidative demands of digestion and absorption by increasing local blood flow and tissue O2 extraction.

Adequacy of tissue oxygenation in intact dog intestine

1984 ◽  
Vol 56 (4) ◽  
pp. 1065-1069 ◽  
Author(s):  
C. M. Grum ◽  
R. G. Fiddian-Green ◽  
G. L. Pittenger ◽  
B. J. Grant ◽  
E. D. Rothman ◽  
...  
Keyword(s):  
Critical Point ◽  
Tissue Oxygenation ◽  
Base Line ◽  
O2 Consumption ◽  
Diffusion Limitation ◽  
Ischemic Group ◽  
O2 Extraction ◽  
The Face ◽  
O2 Delivery ◽  
Hypoxic Group

Changes in O2 consumption, O2 extraction, and intramural pH, resulting from a decreasing O2 delivery, were studied in the intact dog intestine. The O2 delivery was decreased by ischemia, hypoxia, and combined hypoxia-ischemia. A noninvasive approach for determining intramural pH based on the principle of tonometry was used. There was a strong correlation between the changes in intramural pH and intestinal O2 consumption as O2 delivery was decreased. Intramural pH and O2 consumption were initially maintained in the face of decreasing O2 delivery, but after a critical point they decreased. This critical point was 60.3 +/- 1.6% of base-line O2 delivery in the ischemic group and 51.3 +/- 2.7% of base line in the hypoxic-ischemic group. Despite a decrease to 36.0 +/- 5.6% of base-line O2 delivery, the intramural pH and O2 consumption did not decrease in the hypoxic group. O2 extraction increased with decreasing O2 delivery but did not plateau, indicating no diffusion limitation. The data suggest that blood flow is the major factor limiting intestinal O2 consumption. It is concluded that the noninvasive measure of intramural pH is a good marker of the adequacy of tissue oxygenation in canine intestine.

Adrenergic vasoconstriction augments tissue O2 extraction during reductions in O2 delivery

1994 ◽  
Vol 76 (4) ◽  
pp. 1454-1461 ◽  
Author(s):  
L. A. Maginniss ◽  
H. Connolly ◽  
R. W. Samsel ◽  
P. T. Schumacker
Keyword(s):  
Blood Volume ◽  
Supply And Demand ◽  
Sympathetic Tone ◽  
Whole Body ◽  
Metabolic Demand ◽  
O2 Extraction ◽  
Limit Blood Flow ◽  
Anesthetized Dogs ◽  
O2 Supply ◽  
O2 Delivery

When systemic O2 delivery is reduced, increases in systemic O2 extraction are facilitated by sympathetically mediated increases in vascular resistance that limit blood flow to regions with low metabolic demand. Local metabolic vasodilation competes with this vasoconstriction, thereby effecting a balance between tissue O2 supply and demand. This study examined the role of sympathetically mediated vasoconstriction on the critical level of O2 extraction in hindlimb and whole body during progressive reductions in O2 delivery. In anesthetized dogs, the left hindlimb was vascularly isolated and its O2 delivery was decreased in stages by reducing the speed of an occlusive pump. In a normovolemic group (n = 6), blood volume was maintained to minimize sympathetic tone while flow to the hindlimb was reduced. In a hypovolemic group (n = 6), blood volume was removed in stages to augment sympathetic tone progressively while flow to the limb was reduced simultaneously. A phenoxybenzamine group (n = 6) was identical to the hypovolemic group, except that alpha-adrenergic effects were inhibited with phenoxybenzamine (3 mg/kg). The systemic critical O2 extraction ratio in the phenoxybenzamine group (0.60 +/- 0.06) was less than for the hypovolemic group (0.71 +/- 0.04; P = 0.004). In the hindlimb, critical O2 extractions were significantly less in the normovolemic (0.46 +/- 0.17) and phenoxybenzamine (0.49 +/- 0.10) groups compared with the hypovolemic group (0.72 +/- 0.10; P < or = 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)

Neonatal intestinal oxygen consumption during arterial hypoxemia

1983 ◽  
Vol 244 (3) ◽  
pp. G278-G283
Author(s):  
D. I. Edelstone ◽  
D. R. Lattanzi ◽  
M. E. Paulone ◽  
I. R. Holzman
Keyword(s):  
Intestinal Tract ◽  
Concentration Difference ◽  
Fick Principle ◽  
Arterial Blood ◽  
Wide Range ◽  
O2 Extraction ◽  
Neonatal Lambs ◽  
O2 Supply ◽  
Oxygen Requirements ◽  
O2 Delivery

In 12 chronically catheterized neonatal lambs, we determined intestinal tract blood flow (Qi) and O2 consumption (VO2i) at O2 contents of arterial blood (CaO2) ranging from 15.3 to 3.2 ml O2/dl blood. We measured Qi with the radioactive microsphere technique and computed intestinal O2 delivery (DO2i), VO2i, and O2 extraction (VO2i/DO2i) using the Fick principle. In lambs breathing air, mean Qi = 214 ml X min-1 X 100 g intestine-1, DO2i = 27.0 ml O2 X min-1 X 100 g-1, O2 extraction = 21%, and VO2i = 5.6 ml O2 Xmin-1 X 100 g-1. During reductions in CaO2, Qi and DO2i decreased. Intestinal O2 extraction increased sufficiently, however, so that VO2i was maintained over the range of CaO2 from 15.3 to about 6.5 ml O2/dl blood. VO2i was independent of Qi at Qi greater than 160 ml X min-1 X 100 g-1. When CaO2 was reduced below values of 6.5 ml O2/dl blood, corresponding to Qi less than 160 ml X min-1 X 100 g-1, VO2i fell in association with increases in the H+ concentration difference between mesenteric venous and arterial blood. These data indicate that the intestinal tract of the neonatal lamb can meet its oxygen requirements when O2 supply varies over a wide range. When O2 availability reaches a critically low level, intestinal anaerobic metabolism develops as the O2 supply to the neonatal intestinal tract becomes inadequate for the O2 demand.

Regression of calculated variables in the presence of shared measurement error

1987 ◽  
Vol 62 (5) ◽  
pp. 2083-2093 ◽  
Author(s):  
H. H. Stratton ◽  
P. J. Feustel ◽  
J. C. Newell
Keyword(s):  
Measurement Errors ◽  
Regression Coefficient ◽  
Coupling Effect ◽  
Pearson Correlation ◽  
Taylor Series Expansion ◽  
Significance Test ◽  
O2 Consumption ◽  
Measured Variable ◽  
O2 Delivery ◽  
The Relationship

To test hypotheses regarding relations between meaningful parameters, it is often necessary to calculate these parameters from other directly measured variables. For example, the relationship between O2 consumption and O2 delivery may be of interest, although these may be computed from measurements of cardiac output and blood O2 contents. If a measured variable is used in the calculation of two derived parameters, error in the measurement will couple the calculated parameters and introduce a bias, which can lead to incorrect conclusions. This paper presents a method of correcting for this bias in the linear regression coefficient and the Pearson correlation coefficient when calculations involve the nonlinear and linear combination of the measured variables. The general solution is obtained when the first two terms of a Taylor series expansion of the function can be used to represent the function, as in the case of multiplication. A significance test for the hypothesis that the regression coefficient is equal to zero is also presented. Physiological examples are provided demonstrating this technique, and the correction methods are also applied in simulations to verify the adequacy of the technique and to test for the magnitude of the coupling effect. In two previous studies of O2 consumption and delivery, the effect of coupled error is shown to be small when the range of O2 deliveries studied is large, and measurement errors are of reasonable size.

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