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Respiratory Physiology

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Principles of Pulmonary Protection in Heart Surgery

Abstract

Organic evolution has been essentially linked to oxygen (O2) since it was first introduced in the earth’s atmosphere by photosynthesis of early cyanobacteria species some 2.5 billion years ago. In the steady state (i.e., normoxia), most of the oxygen consumed by a cell is used by mitochondria in the generation of adenosine triphosphate (ATP) via oxidative phosphorylation, providing eukaryotic cells with a highly sophisticated survival advantage. Whereas a total of 38 molecules of ATP are generated per molecule of glucose via oxidative phosphorylation, only 2 are produced via anaerobic metabolism. In fact, more than 90% of the oxygen consumption of the body is used for oxidative phosphorylation. Thus, since the chemical reduction of molecular oxygen is the primary source of metabolic energy for most eukaryotic cells, a constant oxygen supply is critical for continued cell function and survival.

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Notes

  1. 1.

    The special symbols in respiratory physiology compiled by Pappenheimer et al.4 are used throughout this chapter.

  2. 2.

    A positive transpulmonary pressure is needed to increase the lung volume.

  3. 3.

    In a healthy subject, the work per liter of ventilation (work per cycle divided by tidal volume) normal value is around 2.4 J/min, with 1 joule (J) the energy needed to move 1 L of gas through a 10-cm H2O pressure gradient.

  4. 4.

    This is because the pleural pressure is lower at the apex than at the base because the weight of the lungs tends to pull it downward, away from the chest wall. If the pleural pressure is decreased, the transpulmonary pressure must be increased, and the alveolar volume increases in this area.

  5. 5.

    If the partial pressure of a gas in the plasma equilibrates with the alveolar partial pressure of the gas within the amount of time the blood is in the pulmonary capillary, its transfer is perfusion limited; if equilibration does not occur within the time the blood is in the capillary, its transfer is diffusion limited.

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Authors and Affiliations

  1. Departamento de Ciencias Fisiológicas, Pontificia Universidad Javeriana, Universidad Militar “Nueva Granada”, Bogotá D.C., Colombia

    Jesús Armando Sánchez-Godoy

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  1. Jesús Armando Sánchez-Godoy
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Correspondence to Jesús Armando Sánchez-Godoy .

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Editors and Affiliations

  1. Federal University of Sao Paulo, Sao Paulo, 04023900, Brazil

    Edmo Atique Gabriel

  2. University of Miami, 1611 N.W. 12th Avenue, Miami, 33136, Florida, USA

    Tomas Salerno

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Sánchez-Godoy, J.A. (2010). Respiratory Physiology. In: Gabriel, E., Salerno, T. (eds) Principles of Pulmonary Protection in Heart Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-308-4_2

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  • DOI: https://doi.org/10.1007/978-1-84996-308-4_2

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