Japanese

The physiology of oxygen delivery and consumption Ryohei YAMAMOTO 1 1Department of Healthcare Epidemiology School of Public Health in the Graduate school of Medicine, Kyoto University pp.103-109
Published Date 2020/1/1
DOI https://doi.org/10.11477/mf.3102200714
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The physiology of oxygen delivery and consumption are very important for the understanding and management of critically ill patients. Heart rate and stroke volume, which define the cardiac output, are not independent variables but interact with each other. Within a certain range of heart rate, the stroke volume is adjusted and cardiac output is kept constant. There is a “best match” range between stroke volume and heart rate that determines cardiac output, but it is difficult to estimate where this is in clinical practice. Several randomized controlled trials show that increasing the hemoglobin concentration beyond a certain level does not improve the prognosis. There is some physiological explanation for this. First, oxygen consumption does not increase even when oxygen delivery exceeds the critical oxygen delivery point. Second, cardiac output decreases due to increased blood viscosity. Last, is the mechanism of oxygen utilization in the microcirculation. At present, however, there is little evidence, and this is a topic for future research.


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