Physiological Comparison of Hemorrhagic Shock and Omax: A Conceptual Framework for Defining the Limitation of Oxygen Delivery

Overview

Journal Exp Biol Med (Maywood)

Specialty Biology

Date 2019 May 2

PMID 31042073

Citations 7

Authors

Victor A Convertino

Kristen R Lye

Natalie J Koons

Michael J Joyner

Affiliations

Soon will be listed here.

Abstract

Disturbance of normal homeostasis occurs when oxygen delivery and energy stores to the body's tissues fail to meet the energy requirement of cells. The work submitted in this review is important because it advances the understanding of inadequate oxygen delivery as it relates to early diagnosis and treatment of circulatory shock and its relationship to disturbance of normal functioning of cellular metabolism in life-threatening conditions of hemorrhage. We explored data from the clinical and exercise literature to construct for the first time a conceptual framework for defining the limitation of inadequate delivery of oxygen by comparing the physiology of hemorrhagic shock caused by severe blood loss to maximal oxygen uptake induced by intense physical exercise. We also provide a translational framework in which understanding the fundamental relationship between the body's reserve to compensate for conditions of inadequate oxygen delivery as a limiting factor to Omax helps to re-evaluate paradigms of triage for improved monitoring of accurate resuscitation in patients suffering from hemorrhagic shock.

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References

Martin D, Levett D, Mythen M, Grocott M . Changes in skeletal muscle oxygenation during exercise measured by near-infrared spectroscopy on ascent to altitude. Crit Care. 2009; 13 Suppl 5:S7. PMC: 2786109. DOI: 10.1186/cc8005. View

Cooke W, Salinas J, Convertino V, Ludwig D, Hinds D, Duke J . Heart rate variability and its association with mortality in prehospital trauma patients. J Trauma. 2006; 60(2):363-70. DOI: 10.1097/01.ta.0000196623.48952.0e. View

Sawka M, Cheuvront S, Kenefick R . Hypohydration and Human Performance: Impact of Environment and Physiological Mechanisms. Sports Med. 2015; 45 Suppl 1:S51-60. PMC: 4672008. DOI: 10.1007/s40279-015-0395-7. View

Hooper T, De Pasquale M, Strandenes G, Sunde G, Ward K . Challenges and possibilities in forward resuscitation. Shock. 2013; 41 Suppl 1:13-20. DOI: 10.1097/SHK.0000000000000096. View

Siegel J, Fabian M, Smith J, Kingston E, Steele K, Wells M . Oxygen debt criteria quantify the effectiveness of early partial resuscitation after hypovolemic hemorrhagic shock. J Trauma. 2003; 54(5):862-80; discussion 880. DOI: 10.1097/01.TA.0000066186.97206.39. View

Brooks G . The Science and Translation of Lactate Shuttle Theory. Cell Metab. 2018; 27(4):757-785. DOI: 10.1016/j.cmet.2018.03.008. View

Kasnitz P, Druger G, Yorra F, Simmons D . Mixed venous oxygen tension and hyperlactatemia. Survival in severe cardiopulmonary disease. JAMA. 1976; 236(6):570-4. View

Stone Jr M, Kalata S, Liveris A, Adorno Z, Yellin S, Chao E . End-tidal CO on admission is associated with hemorrhagic shock and predicts the need for massive transfusion as defined by the critical administration threshold: A pilot study. Injury. 2016; 48(1):51-57. DOI: 10.1016/j.injury.2016.07.007. View

Convertino V, Sawka M . Wearable technology for compensatory reserve to sense hypovolemia. J Appl Physiol (1985). 2017; 124(2):442-451. DOI: 10.1152/japplphysiol.00264.2017. View

10.

Convertino V, Grudic G, Mulligan J, Moulton S . Estimation of individual-specific progression to impending cardiovascular instability using arterial waveforms. J Appl Physiol (1985). 2013; 115(8):1196-202. DOI: 10.1152/japplphysiol.00668.2013. View

11.

McManus J, Ryan K, Morton M, Rickards C, Cooke W, Convertino V . Limitations of end-tidal CO2 as an early indicator of central hypovolemia in humans. Prehosp Emerg Care. 2008; 12(2):199-205. DOI: 10.1080/10903120801907182. View

12.

Mortensen S, Damsgaard R, Dawson E, Secher N, Gonzalez-Alonso J . Restrictions in systemic and locomotor skeletal muscle perfusion, oxygen supply and VO2 during high-intensity whole-body exercise in humans. J Physiol. 2008; 586(10):2621-35. PMC: 2464345. DOI: 10.1113/jphysiol.2007.149401. View

13.

Knight D, Schaffartzik W, Poole D, Hogan M, Bebout D, Wagner P . Effects of hyperoxia on maximal leg O2 supply and utilization in men. J Appl Physiol (1985). 1993; 75(6):2586-94. DOI: 10.1152/jappl.1993.75.6.2586. View

14.

Janak J, Howard J, Goei K, Weber R, Muniz G, Hinojosa-Laborde C . Predictors of the Onset of Hemodynamic Decompensation During Progressive Central Hypovolemia: Comparison of the Peripheral Perfusion Index, Pulse Pressure Variability, and Compensatory Reserve Index. Shock. 2015; 44(6):548-53. DOI: 10.1097/SHK.0000000000000480. View

15.

Bassett Jr D . Scientific contributions of A. V. Hill: exercise physiology pioneer. J Appl Physiol (1985). 2002; 93(5):1567-82. DOI: 10.1152/japplphysiol.01246.2001. View

16.

Convertino V, Rickards C, Lurie K, Ryan K . Hyperventilation in response to progressive reduction in central blood volume to near syncope. Aviat Space Environ Med. 2009; 80(12):1012-7. DOI: 10.3357/asem.2598.2009. View

17.

Wagner P . Systemic oxygen transport and utilization. J Breath Res. 2011; 2(2):024001. DOI: 10.1088/1752-7155/2/2/024001. View

18.

Younes M, Burks J . Breathing pattern during and after exercise of different intensities. J Appl Physiol (1985). 1985; 59(3):898-908. DOI: 10.1152/jappl.1985.59.3.898. View

19.

Rixen D, Siegel J . Bench-to-bedside review: oxygen debt and its metabolic correlates as quantifiers of the severity of hemorrhagic and post-traumatic shock. Crit Care. 2005; 9(5):441-53. PMC: 1297598. DOI: 10.1186/cc3526. View

20.

Gourine A, Ackland G . Cardiac Vagus and Exercise. Physiology (Bethesda). 2018; 34(1):71-80. PMC: 6383634. DOI: 10.1152/physiol.00041.2018. View