Skip to main content

Physiological and Pathological Oxygen Supply Dependency

  • Chapter
Tissue Oxygen Utilization

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 12))

Abstract

In some critically ill patients, particularly those with the Adult Respiratory Distress Syndrome (ARDS) or sepsis, oxygen (O2) uptake has been observed to change in the same direction with any change in O2 delivery (the product of cardiac output and arterial O2 concentration). These changes have been seen at levels of O2 delivery where O2 uptake is normally independent of delivery. The principal reason appears to be an inability of peripheral tissues to alter O2 extraction appropriately. There are, however, several features of this pathological O2 supply dependency which are still poorly understood and which may have serious implications for the outcome in any particular case.

Funds to support the research reported here were obtained from the National Institutes of Health (HL 26927) and Fisons Pharmaceuticals plc.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Nelson DP, King CE, Dodd SL, Schumacker PT, Cain SM (1987) Systemic and intestinal limits of oxygen extraction in the dog. J Appl Physiol 63: 387–394

    PubMed  CAS  Google Scholar 

  2. Mohsenifar Z, Goldbach P, Tashkin DP, Campisi DJ (1983) Relationship between O2 delivery and O2 consumption in the adult respiratory distress syndrome. Chest 84: 267–271

    Article  PubMed  CAS  Google Scholar 

  3. Tuchschmidt J, Fried J, Swinney R, Sharma OP (1989) Early hemodynamic correlates of survival in patients with septic shock. Crit Care Med 17: 719–723

    Article  PubMed  CAS  Google Scholar 

  4. Cain SM (1986) Assessment of tissue oxygenation. Crit Care Clin 2: 537–550

    PubMed  CAS  Google Scholar 

  5. Cain SM (1989) Mechanisms of limited oxygen delivery in sepsis and adult respiratory distress syndrome. In: Reinhart K, Eyrich K (eds) Sepsis: an interdisciplinary challenge. Springer, Berlin Heidelberg New York Tokyo, pp 140–147

    Google Scholar 

  6. Gutierrez G, Pohil RJ (1986) Oxygen consumption is linearly related to OZ supply in critically ill patients. J Crit Care 1: 45–53

    Article  Google Scholar 

  7. Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 317: 397–403

    Article  PubMed  CAS  Google Scholar 

  8. Kaufman BS, Rackow EC, Falk JL (1984) The relationship between oxygen delivery and consumption during fluid resuscitation of hypovolemic and septic shock. Chest 85: 336–340

    Article  PubMed  CAS  Google Scholar 

  9. Haupt MT, Gilbert EM, Carlson RW (1985) Fluid loading increases oxygen consumption in septic patients with lactic acidosis. Am Rev Respir Dis 131: 912–916

    PubMed  CAS  Google Scholar 

  10. Gilbert EM, Haupt MT, Mandanas RY, Huaringa AJ, Carlson RW (1986) The effect of fluid loading, blood transfusion, and catecholamine infusion on oxygen delivery and consumption in patients with sepsis. Am Rev Respir Dis 134: 873–878

    PubMed  CAS  Google Scholar 

  11. Astiz ME, Rackow EC, Falk JL, Kaufman BS, Weil MH (1987) Oxygen delivery and consumption in patients with hyperdynamic septic shock. Crit Care Med 15: 26–28

    Article  PubMed  CAS  Google Scholar 

  12. Shibutani K, Komatsu T, Kubal K, Sanchala V, Kumar V, Bizzari DV (1983) Critical level of oxygen delivery in anesthetized man. Crit Care Med 11: 640–643

    Article  PubMed  CAS  Google Scholar 

  13. Komatsu T, Shibutani K, Okamoto K, Kumar V, Kubal K, Sanchala V, Lees DE (1987) Critical level of oxygen delivery after cardiopulmonary bypass. Crit Care Med 15: 194–197

    Article  PubMed  CAS  Google Scholar 

  14. Broder G, Weil MH (1964) Excess lactate: an index of reversibility of shock in human patients. Science 143: 1457–1459

    Article  PubMed  CAS  Google Scholar 

  15. Nelson DP, Beyer C, Samsel RW, Wood LDH, Schumacker PT (1987) Pathologic supply-dependence of 02 uptake during bacteremia in dogs. J Appl Physiol 63: 1487–1492

    PubMed  CAS  Google Scholar 

  16. Nelson DP, Samsel RW, Wood LDH, Schumacker PT (1988) Pathological supply dependence of systemic and intestinal 02 uptake during endotoxemia. J Appl Physiol 64: 2410–2419

    PubMed  CAS  Google Scholar 

  17. Samsel RW, Nelson DP, Sanders WM, Wood LDH, Schumacker PT (1988) Effect of endotoxin on systemic and skeletal muscle 02 extraction. J Appl Physiol 65: 1377–1382

    PubMed  CAS  Google Scholar 

  18. Samsel RW, Schumacker PT (1988) Determination of the critical 02 delivery from experimental data: sensitivity to error. J Appl Physiol 64: 2074–2082

    PubMed  CAS  Google Scholar 

  19. Mela L, Bacalzo LV Jr, Miller LD (1971) Defective oxidative metabolism of rat liver mitochondria in hemorrhagic and endotoxin shock. Am J Physiol 220: 571–577

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Cain, S.M. (1991). Physiological and Pathological Oxygen Supply Dependency. In: Gutierrez, G., Vincent, J.L. (eds) Tissue Oxygen Utilization. Update in Intensive Care and Emergency Medicine, vol 12. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84169-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-84169-9_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-52472-4

  • Online ISBN: 978-3-642-84169-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics