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Tissue Oxygen Tension in the Anesthetized Patient

Tissue Oxygen Tension in the Anesthetized Patient Abstract NORMAL cell metabolism and function depend on the constant presence of adequate amounts of oxygen within the cell. The amount of molecular oxygen in tissue (ie, tissue oxygen tension) is determined by a host of interrelated factors under normal conditions: Coefficient of oxygen diffusion Rate of delivery of oxygen to tissue Amount of oxygen in arterial blood Alveolar oxygen tension Oxygen tension in inspired air Alveolar ventilation Ventilation: perfusion ratio Pulmonary diffusion capacity Solubility of oxygen in plasma Amount of hemoglobin Rate of delivery of arterial blood to tissues Cardiac output Blood pressure State of peripheral vasculature (vasoconstricted or vasodilated) Arterio-venous shunts Rate at which oxygen leaves blood Oxygen dissociation curve Oxygen solubility in plasma Rate of consumption of oxygen by tissue Work Drugs Endocrine Epinephrine Corticosteroids Thyroxine Insulin Temperature Under conditions as physiologically and pharmacologically complex as clinical anesthesia, the determinants of tissue oxygenation become even more complex. Some References 1. Krogh, A.: The Number and Distribution of Capillaries in Muscles With Calculations of the Oxygen Pressure Head Necessary for Supplying the Tissue , J Physiol 52:409, 1919. 2. Kety, S.S.: Determinants of Tissue Oxygen Tension , Fed Proc 16:666, 1957. 3. Hudson, J.A., and Cater, D.B.: An Analysis of Factors Affecting Tissue Oxygen Tension , Proc Roy Soc (Biol) 161:247, 1964.Crossref 4. Longmuir, I.S., and Bourke, A.: The Measurement of the Diffusion of Oxygen Through Respiring Tissues , Biochem J 76:225, 1960. 5. Bergofsky, E.H.; Jacobson, J.H., II; and Fishman, A.P.: The Use of Lymph for the Measurement of Gas Tensions in Interstitial Fluid and Tissues , J Clin Invest 41:1971, 1962.Crossref 6. Kirk, E.S., and Honig, C.R.: Nonuniform Distribution of Blood Flow and Gradients of Oxygen Tension Within the Heart , Amer J Physiol 207:661, 1964. 7. Hamilton, W.K., and Eastwood, D.W.: Study of Denitrogenation With Some Inhalation Anesthetic Systems , Anesthesiology 16:861, 1955.Crossref 8. Swartz, C.H.; Adriani, J.; and Mih, A.: Semiclosed Inhalers: Studies of Oxygen and Carbon Dioxide Tensions During Various Conditions of Use , Anesthesiology 14:437, 1953.Crossref 9. Ridley, R.W.; Faulconer, A., Jr.; and Osborn, J.E.: Concentrations of Oxygen, Nitrous Oxide, Nitrogen and Ether and Their Correlation With Certain Physiologic Variables During Surgical Anesthesia in Man , Anesthesiology 12:276, 1951.Crossref 10. Faulconer, A., Jr., and Latterell, K.E.: Tensions of Oxygen and Ether Vapor During Use of the Semi-Open, Air-Ether Method of Anesthesia , Anesthesiology 10:247, 1949.Crossref 11. Fink, B.R.: Diffusion Anoxia , Anesthesiology 16:511, 1955.Crossref 12. Heller, M.L., and Watson, T.R.: Polargraphic Study of Arterial Oxygenation During Apnea in Man , New Eng J Med 264:326, 1961.Crossref 13. Bendixen, H.H.; Hedley-White, J.; and Laver, M.B.: Impaired Oxygenation in Surgical Patients During General Anaesthesia With Controlled Ventilation: A Concept of Atelectasis , New Eng J Med 269:991, 1963.Crossref 14. Bendixen, H.H., et al: Impaired Oxygenation During Spontaneous Ventilation in Anaesthetized Patients , Anesthesiology 25:297, 1964.Crossref 15. Conway, C.M., and Payne, J.P.: Hypoxaemia Associated With Anaesthesia and Controlled Respiration , Lancet 1:12, 1964.Crossref 16. Munn, J.F., and Payne, J.P.: Hypoxaemia After General Anaesthesia , Lancet 2:631, 1962. 17. Bjurstedt, H., et al: Effects of Posture on Alveolar-Arterial CO2 and O2 Differences and on Alveolar Dead Space in Man , Acta Physiol Scand 54:65, 1962.Crossref 18. Gardiner, A.J.S., and Palmer, K.N.V.: Effect of Premedication and General Anaesthesia on Arterial Blood Gases , Brit Med J 1433, ( (Dec 5) ) 1964. 19. Tomlin, P.J.; Conway, CM.; and Payne, J.P.: Hypoxaemia Due to Atropine , Lancet 1:14, 1964.Crossref 20. Laver, M.B., et al: Lung Volume, Compliance and Arterial Oxygen Tensions During Controlled Ventilation , J Appl Physiol 19:725, 1964. 21. Frumin, M.J., et al: Alveolar-Arterial O2 Differences During Artificial Respiration in Man , J Appl Physiol 14:694, 1959. 22. Ayres S.M.; Criscitiello, A.; and Grabovsky, E.: Components of Alveolar-Arterial O2 Difference in Normal Man , J Appl Physiol 19:43, 1964. 23. Bergofsky, E.H., et al: Tissue Oxygen and Carbon Dioxide Tensions During Hyperbaric Oxygenation , JAMA 189:841, 1964.Crossref 24. Said, S.E., and Banerjee, C.M.: Venous Admixture to the Pulmonary Circulation in Human Subjects Breathing 100% O2 J Clin Invest 42:507, 1963.Crossref 25. Hedley-White, J., and Laver, M.B.: O2 Solubility in Blood and Temperature Correction Factors for pO2 , J Appl Physiol 19:901, 1964. 26. Murray, J.F.; Gold, P.; and Johnson, B.L., Jr.: Systemic Oxygen Transport in Induced Normovolemic Anemia and Polycythemia , Amer J Physiol 203:720, 1962. 27. Bader, R.A.; Bader, M.E.; and Duberstein, J.L.: Polycythemia Vera and Arterial Oxygen Saturation , Amer J Med 34:435, 1963.Crossref 28. Lertzman, M., et al: Hypoxia in Polycythemia Vera , Ann Intern Med 60:409, 1964.Crossref 29. Cotes, J.E.; Pisa, Z.; and Thomas, A.J.: Effect of Breathing Oxygen Upon Cardiac Output, Heart Rate, Ventilation, Systemic and Pulmonary Blood Pressure in Patients With Chronic Lung Disease , Clin Sci 25:305, 1963. 30. Daley, W.J., and Bondurant, S.: Effects of Oxygen Breathing on the Heart Rate, Blood Pressure and Cardiac Index of Normal Man Resting, With Reactive Hyperemia and After Atropine , J Clin Invest 41:126, 1962.Crossref 31. Eggers, G.W.N., Jr., et al: Hemodynamic Response to Oxygen Breathing , J Appl Physiol 17:75, 1962. 32. Greene, N.M., and Willenkin, R.L.: Skeletal Muscle Oxygen Tension and Metabolism During Hemorrhagic Hypotension and Subsequent Vasopressor Administration , Yale J Biol Med 35:429, 1963. 33. Freeman, J., and Nunn, J.F.: Ventilation-Perfusion Relationships After Hemorrhage , Clin Sci 24:135, 1963. 34. Gerst, P.H.; Rattenborg, C.; and Holaday, D.A.: Changes in Pulmonary Circulation and Respiratory Gas Exchange Following Hemorrhage , Fed Proc 17:53, 1958. 35. Davis, M.T., and Greene, N.M.: Polargraphic Studies of Skin Oxygen Tension Following Sympathetic Denervation , J Appl Physiol 14:961, 1959. 36. Willenkin, R.L., and Greene, N.M.: Skeletal Muscle Oxygen Tension and Metabolism During Induced Hypotension and During Vasopressor Administration , Anesthesiology 24:168, 1963.Crossref 37. Bird, A.D., and Telfer, A.B.M.: Effect of Hyperbaric Oxygen on Peripheral Blood Flow , Lancet 1:355, 1965.Crossref 38. Jacobson, I.; Harper, A.M.; and McDowall, D.G.: The Effects of Oxygen at 1 and 2 Atmospheres on the Blood Flow and Oxygen Uptake of the Cerebral Cortex , Surg Gynec Obstet 119:737, 1964. 39. Lambertsen, C.J., et al: Oxygen Toxicity: Effects in Man of Oxygen Inhalation at 1 and 3.5 Atmospheres Upon Blood Gas Transport, Cerebral Circulation and Cerebral Metabolism , J Appl Physiol 5:471, 1953. 40. Rennie, D.W., and Knox, F.G.: Effect of O2 at High Ambient Pressure on Blood Flow and O2 Consumption of the Kidney , J Appl Physiol 19:1095, 1964. 41. Salem, E.S., et al: Effect of Respiratory Gases on Compliance of Intrapulmonary Arteries and Veins , J Appl Physiol 19:1202, 1964. 42. Sugioka, K., and Davis, D.A.: Hyperventilation With Oxygen: A Possible Cause of Cerebral Hypoxia , Anesthesiology 21:135, 1960.Crossref 43. Greene, N.M.; Davis, M.T.; and Bell, J.K.S.: Effects of General Anesthetics on Tissue Oxygen Tension in Man: Skin , Anesthesiology 20:830, 1959.Crossref 44. Greene, N.M., and Bull, M.H.: Oxygen Tension Monitoring During Clinical Anesthesia , Arch Surg 88:225, 1964.Crossref 45. Greene, N.M.: Lactate, Pyruvate, and Excess Lactate Production in Anesthetized Man , Anesthesiology 22:404, 1961.Crossref 46. Danoff, D.S., and Greene, N.M.: Vasodilation and the Metabolic Response to Hemorrhage , Surgery 55:820, 1964. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Tissue Oxygen Tension in the Anesthetized Patient

Archives of Surgery , Volume 92 (2) – Feb 1, 1966

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320200004002
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Abstract

Abstract NORMAL cell metabolism and function depend on the constant presence of adequate amounts of oxygen within the cell. The amount of molecular oxygen in tissue (ie, tissue oxygen tension) is determined by a host of interrelated factors under normal conditions: Coefficient of oxygen diffusion Rate of delivery of oxygen to tissue Amount of oxygen in arterial blood Alveolar oxygen tension Oxygen tension in inspired air Alveolar ventilation Ventilation: perfusion ratio Pulmonary diffusion capacity Solubility of oxygen in plasma Amount of hemoglobin Rate of delivery of arterial blood to tissues Cardiac output Blood pressure State of peripheral vasculature (vasoconstricted or vasodilated) Arterio-venous shunts Rate at which oxygen leaves blood Oxygen dissociation curve Oxygen solubility in plasma Rate of consumption of oxygen by tissue Work Drugs Endocrine Epinephrine Corticosteroids Thyroxine Insulin Temperature Under conditions as physiologically and pharmacologically complex as clinical anesthesia, the determinants of tissue oxygenation become even more complex. Some References 1. Krogh, A.: The Number and Distribution of Capillaries in Muscles With Calculations of the Oxygen Pressure Head Necessary for Supplying the Tissue , J Physiol 52:409, 1919. 2. Kety, S.S.: Determinants of Tissue Oxygen Tension , Fed Proc 16:666, 1957. 3. Hudson, J.A., and Cater, D.B.: An Analysis of Factors Affecting Tissue Oxygen Tension , Proc Roy Soc (Biol) 161:247, 1964.Crossref 4. Longmuir, I.S., and Bourke, A.: The Measurement of the Diffusion of Oxygen Through Respiring Tissues , Biochem J 76:225, 1960. 5. Bergofsky, E.H.; Jacobson, J.H., II; and Fishman, A.P.: The Use of Lymph for the Measurement of Gas Tensions in Interstitial Fluid and Tissues , J Clin Invest 41:1971, 1962.Crossref 6. Kirk, E.S., and Honig, C.R.: Nonuniform Distribution of Blood Flow and Gradients of Oxygen Tension Within the Heart , Amer J Physiol 207:661, 1964. 7. Hamilton, W.K., and Eastwood, D.W.: Study of Denitrogenation With Some Inhalation Anesthetic Systems , Anesthesiology 16:861, 1955.Crossref 8. Swartz, C.H.; Adriani, J.; and Mih, A.: Semiclosed Inhalers: Studies of Oxygen and Carbon Dioxide Tensions During Various Conditions of Use , Anesthesiology 14:437, 1953.Crossref 9. Ridley, R.W.; Faulconer, A., Jr.; and Osborn, J.E.: Concentrations of Oxygen, Nitrous Oxide, Nitrogen and Ether and Their Correlation With Certain Physiologic Variables During Surgical Anesthesia in Man , Anesthesiology 12:276, 1951.Crossref 10. Faulconer, A., Jr., and Latterell, K.E.: Tensions of Oxygen and Ether Vapor During Use of the Semi-Open, Air-Ether Method of Anesthesia , Anesthesiology 10:247, 1949.Crossref 11. Fink, B.R.: Diffusion Anoxia , Anesthesiology 16:511, 1955.Crossref 12. Heller, M.L., and Watson, T.R.: Polargraphic Study of Arterial Oxygenation During Apnea in Man , New Eng J Med 264:326, 1961.Crossref 13. Bendixen, H.H.; Hedley-White, J.; and Laver, M.B.: Impaired Oxygenation in Surgical Patients During General Anaesthesia With Controlled Ventilation: A Concept of Atelectasis , New Eng J Med 269:991, 1963.Crossref 14. Bendixen, H.H., et al: Impaired Oxygenation During Spontaneous Ventilation in Anaesthetized Patients , Anesthesiology 25:297, 1964.Crossref 15. Conway, C.M., and Payne, J.P.: Hypoxaemia Associated With Anaesthesia and Controlled Respiration , Lancet 1:12, 1964.Crossref 16. Munn, J.F., and Payne, J.P.: Hypoxaemia After General Anaesthesia , Lancet 2:631, 1962. 17. Bjurstedt, H., et al: Effects of Posture on Alveolar-Arterial CO2 and O2 Differences and on Alveolar Dead Space in Man , Acta Physiol Scand 54:65, 1962.Crossref 18. Gardiner, A.J.S., and Palmer, K.N.V.: Effect of Premedication and General Anaesthesia on Arterial Blood Gases , Brit Med J 1433, ( (Dec 5) ) 1964. 19. Tomlin, P.J.; Conway, CM.; and Payne, J.P.: Hypoxaemia Due to Atropine , Lancet 1:14, 1964.Crossref 20. Laver, M.B., et al: Lung Volume, Compliance and Arterial Oxygen Tensions During Controlled Ventilation , J Appl Physiol 19:725, 1964. 21. Frumin, M.J., et al: Alveolar-Arterial O2 Differences During Artificial Respiration in Man , J Appl Physiol 14:694, 1959. 22. Ayres S.M.; Criscitiello, A.; and Grabovsky, E.: Components of Alveolar-Arterial O2 Difference in Normal Man , J Appl Physiol 19:43, 1964. 23. Bergofsky, E.H., et al: Tissue Oxygen and Carbon Dioxide Tensions During Hyperbaric Oxygenation , JAMA 189:841, 1964.Crossref 24. Said, S.E., and Banerjee, C.M.: Venous Admixture to the Pulmonary Circulation in Human Subjects Breathing 100% O2 J Clin Invest 42:507, 1963.Crossref 25. Hedley-White, J., and Laver, M.B.: O2 Solubility in Blood and Temperature Correction Factors for pO2 , J Appl Physiol 19:901, 1964. 26. Murray, J.F.; Gold, P.; and Johnson, B.L., Jr.: Systemic Oxygen Transport in Induced Normovolemic Anemia and Polycythemia , Amer J Physiol 203:720, 1962. 27. Bader, R.A.; Bader, M.E.; and Duberstein, J.L.: Polycythemia Vera and Arterial Oxygen Saturation , Amer J Med 34:435, 1963.Crossref 28. Lertzman, M., et al: Hypoxia in Polycythemia Vera , Ann Intern Med 60:409, 1964.Crossref 29. Cotes, J.E.; Pisa, Z.; and Thomas, A.J.: Effect of Breathing Oxygen Upon Cardiac Output, Heart Rate, Ventilation, Systemic and Pulmonary Blood Pressure in Patients With Chronic Lung Disease , Clin Sci 25:305, 1963. 30. Daley, W.J., and Bondurant, S.: Effects of Oxygen Breathing on the Heart Rate, Blood Pressure and Cardiac Index of Normal Man Resting, With Reactive Hyperemia and After Atropine , J Clin Invest 41:126, 1962.Crossref 31. Eggers, G.W.N., Jr., et al: Hemodynamic Response to Oxygen Breathing , J Appl Physiol 17:75, 1962. 32. Greene, N.M., and Willenkin, R.L.: Skeletal Muscle Oxygen Tension and Metabolism During Hemorrhagic Hypotension and Subsequent Vasopressor Administration , Yale J Biol Med 35:429, 1963. 33. Freeman, J., and Nunn, J.F.: Ventilation-Perfusion Relationships After Hemorrhage , Clin Sci 24:135, 1963. 34. Gerst, P.H.; Rattenborg, C.; and Holaday, D.A.: Changes in Pulmonary Circulation and Respiratory Gas Exchange Following Hemorrhage , Fed Proc 17:53, 1958. 35. Davis, M.T., and Greene, N.M.: Polargraphic Studies of Skin Oxygen Tension Following Sympathetic Denervation , J Appl Physiol 14:961, 1959. 36. Willenkin, R.L., and Greene, N.M.: Skeletal Muscle Oxygen Tension and Metabolism During Induced Hypotension and During Vasopressor Administration , Anesthesiology 24:168, 1963.Crossref 37. Bird, A.D., and Telfer, A.B.M.: Effect of Hyperbaric Oxygen on Peripheral Blood Flow , Lancet 1:355, 1965.Crossref 38. Jacobson, I.; Harper, A.M.; and McDowall, D.G.: The Effects of Oxygen at 1 and 2 Atmospheres on the Blood Flow and Oxygen Uptake of the Cerebral Cortex , Surg Gynec Obstet 119:737, 1964. 39. Lambertsen, C.J., et al: Oxygen Toxicity: Effects in Man of Oxygen Inhalation at 1 and 3.5 Atmospheres Upon Blood Gas Transport, Cerebral Circulation and Cerebral Metabolism , J Appl Physiol 5:471, 1953. 40. Rennie, D.W., and Knox, F.G.: Effect of O2 at High Ambient Pressure on Blood Flow and O2 Consumption of the Kidney , J Appl Physiol 19:1095, 1964. 41. Salem, E.S., et al: Effect of Respiratory Gases on Compliance of Intrapulmonary Arteries and Veins , J Appl Physiol 19:1202, 1964. 42. Sugioka, K., and Davis, D.A.: Hyperventilation With Oxygen: A Possible Cause of Cerebral Hypoxia , Anesthesiology 21:135, 1960.Crossref 43. Greene, N.M.; Davis, M.T.; and Bell, J.K.S.: Effects of General Anesthetics on Tissue Oxygen Tension in Man: Skin , Anesthesiology 20:830, 1959.Crossref 44. Greene, N.M., and Bull, M.H.: Oxygen Tension Monitoring During Clinical Anesthesia , Arch Surg 88:225, 1964.Crossref 45. Greene, N.M.: Lactate, Pyruvate, and Excess Lactate Production in Anesthetized Man , Anesthesiology 22:404, 1961.Crossref 46. Danoff, D.S., and Greene, N.M.: Vasodilation and the Metabolic Response to Hemorrhage , Surgery 55:820, 1964.

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1966

References