Novel Approaches to Improve Tissue Oxygen Extraction Capabilities: Lessons Learned from Experimental Septic Shock Models

  • H. Zhang
  • J. L. Vincent
Conference paper


Under basal conditions, O2 uptake (VO2) reflects metabolic demand and is independent of O2 delivery (DO2). When DO2 is reduced by a decrease in either cardiac output or arterial O2 content, VO2 can be maintained at a fairly constant value over a broad range of DO2 through increases in the O2 extraction ratio (O2ER). However, when DO2 is further decreased to a critical level, termed DO2crit, VO2 starts to decrease in a roughly linear fashion towards a supply-dependent condition. The critical DO2 (DO2crit) is the point at which compensatory responses fail to maintain VO2. It is commonly found to be the value of DO2 at the intersection of two lines that are fitted to the O2 supply-independent and supply-dependent portions of the typically biphasic relationship of VO2 to DO2. The critical O2ER (O2ERcrit), reflecting the tissue O2 extraction capabilities, is the ratio of VO2 over DO2 at the DO2crit. Reduction in DO2 is associated with an increase in systemic vascular resistance until DO2crit is reached. Below DO2crit, this vasoconstrictive response is blunted, which may help to increase O2 extraction by increasing the density of perfused capillaries within the tissues and thereby shortening the diffusion distance between the capillaries and the cells.


Septic Shock Cardiac Tamponade Endotoxic Shock Stagnant Hypoxia Tumor Necrosis Factor Production 
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Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • H. Zhang
  • J. L. Vincent

There are no affiliations available

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