FLOW REDISTRIBUTION DURING PROGRESSIVE HEMORRHAGE IS A DETERMINANT OF CRITICAL O2 DELIVERY

被引:102
作者
SCHLICHTIG, R
KRAMER, DJ
PINSKY, MR
机构
[1] UNIV PITTSBURGH,DEPT ANESTHESIOL & CRIT CARE MED,PITTSBURGH,PA 15240
[2] UNIV PITTSBURGH,DEPT INTERNAL MED,PITTSBURGH,PA 15240
[3] UNIV PITTSBURGH,DEPT SURG,PITTSBURGH,PA 15240
关键词
BLOOD FLOW REDISTRIBUTION; OXYGEN CONSUMPTION; CRITICAL DELIVERY; SHOCK; SUPPLY DEPENDENCE;
D O I
10.1152/jappl.1991.70.1.169
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
O2 consumption (VO2) of anesthetized whole mammals is independent of O2 delivery (DO2) until DO2 declines to a critical value (DO2c). Below this value, VO2 becomes O2 supply dependent. We assessed the influence of whole body DO2 redistribution among organs with respect to the commencement of O2 supply dependency. We measured DO2, VO2, and DO2c of whole body, liver, intestine, kidney, and remaining carcass in eight mongrel dogs during graded progressive hemorrhage. Whole body DO2 was redistributed such that the organ-to-whole body DO2 ratio declined for liver and kidney and increased for carcass. We then created a mathematical model wherein each organ-to-whole body DO2 ratio remained approximately constant at all values of whole body DO2 and assigned organ VO2 to predicted organ DO2 by interpolation and extrapolation of observed VO2-DO2 plots. The model predicted that O2 supply dependency without redistribution would have commenced at a higher value of whole body DO2 for whole body (8.11 +/- 0.89 vs. 6.98 +/- 1.16 ml.kg-1.min-1, P < 0.05) and carcass (6.83 +/- 1.16 vs. 5.06 +/- 1.15 ml.kg-1.min-1, P < 0.01) and at a lower value of whole body DO2 for liver (6.33 +/- 1.86 vs. 7.59 +/- 1.95, ml.kg-1.min-1, P < 0.02) and kidney (1.25 +/- 0.64 vs. 4.54 +/- 1.29 ml.kg-1.min-1, P < 0.01). We conclude that redistribution of whole body DO2 among organs facilitates whole body O2 regulation.
引用
收藏
页码:169 / 178
页数:10
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