Principles of Oxygen Transport and Gas Exchange: Unanswered Questions

  • C. W. Bryan-Brown
  • G. Gutierrez
Conference paper
Part of the Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine book series (A+I, volume 180)

Abstract

The basics of oxygen transport were well established by 1920 in Barcroft’s classical lecture, “On Anoxaemia” [1]. The anoxic, anemic, and stagnant anoxemias then became part of standard physiological teaching. With Haldane’s synthesis, even affinity hypoxia was considered a possible cause of inadequate oxygen delivery, when the hemoglobin might not release oxygen normally [2]. The necessity for maintaining oxygenation, hemoglobin, and cardiac output in the compromised patient was again stressed by Nunn and Freeman in 1964 [3], at a time when most of the factors were beginning to be available as clinical measurements. Also, Valtis and Kennedy [4] had found that oxygen delivery was temporarily defective in patients who had received as little as 3 units of banked blood. In spite of research that has been in progress for 100 years, there are some fundamental questions on the principles of oxygen transport where answers are far from fully defined, such as the optimal levels of arterial oxygen tension (PaO2) and hemoglobin concentration ([Hb]), the best position of the oxyhemoglobin dissociation curve, how to assess the adequacy of oxygen uptake and delivery, and the nature of the forces that limit oxygenation of the tissues when delivery is compromised. The purpose of this article is to investigate these questions and possible answers.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • C. W. Bryan-Brown
  • G. Gutierrez

There are no affiliations available

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