Oxygen Delivery

Muhammad Husni Thamrin

SMF Anestesi dan Terapi
Intensif
RS DR Moewardi

 The single-cell organism (e.g. amoeba) requires

oxygen for its survival and obtains it from the
environment from simple diffusion. This relies
upon Ficks first law of diffusion:
O2 diffusion = K x A/T x P1

K= konstanta gas
A= luasnya permukaan membran
T= tebalnya membran
P= perbedaan tekanan parsial antar membran

OXYGEN DELIVERY
Transport of oxygen to the cells can thus be divided
into six simple steps reliant only on the laws of
physics:
1. convection of oxygen from the environment into
the body (ventilation)
2. diffusion of oxygen into the blood (oxygen uptake)
3. reversible chemical bonding with haemoglobin
4. convective transport of oxygen to the tissues
(cardiac output: CO)
5. diffusion into the cells and organelles
6. the redox state of the cell

STEP 1: CONVECTION
VENTILATION
The first step occurs in the lung in the
form of pulmonary ventilation.
At sea level the partial pressure of
oxygen in environmental air is
approximately 160 mmHg
at the alveolus the PaO2 is 100 mmHg.
Much of oxygentherapy is based on
increasing oxygen delivery into thelungs,
whether it be by masks or other devices

STEP 2: DIFFUSION ALVEOLUS TO

BLOOD
Oxygen within the alveolus diffuses
across the alveolarcapillary membrane.
The average thickness of the alveolar
capillary membrane is 0.3 mm and the
surface area of the respiratory
membrane is 50100 m2.
This leads to a PaO2 in the pulmonary
capillaries of approximately 90 mmHg.

STEP 2 contd
the problems seen in the critically ill where
two mechanisms predominate:
1. the thickness and barrier effect of the
space between alveolus and capillary
2. the relationship between perfusion and
ventilation at alveolar level (V/Q ratio)
Good ventilation and good perfusion is ideal
while poorventilation and poor perfusion is
bad

STEP 3: HAEMOGLOBIN
BINDING
Oxygen is poorly soluble in water,
having a solubility of 0.003 082
g/100 g H2O.
Having diffused across the alveolar
capillary membrane, the oxygen
binds rapidly to the respiratory
pigment haemoglobin

STEP 4: CONVECTION
CARDIOVASCULAR
Convection of oxygen by the cardiovascular
system is influenced mainly centrally by CO
and peripherally by local controls of the
regional perfusion of the tissues.
The delivery of oxygen also relies on the
concentrationof oxygen in the blood (CaO2).
This is calculated by thefollowing formula:
Cao2 = ([Hb](g/dl)x 1.34 x Sao2) +
(0.003xPao2)