The oxygen status of the arterial blood revised: relevant oxygen parameters for monitoring the arterial oxygen availability. 1990

O Siggaard-Andersen, and I H Gøthgen, and P D Wimberley, and N Fogh-Andersen
Department of Clinical Chemistry, Herlev Hospital, Denmark.

The new generation of very accurate multi-wavelength oximeters, e.g. OSM3, for in vitro measurement of the hemoglobin oxygen saturation, total hemoglobin concentration, and carboxy- and methemoglobin fractions opens new aspects of oxygen monitoring. Combined with the data from the blood gas analyzer (e.g. ABL300) these very accurate measurements allow the calculation of several derived oxygen parameters on the basis of a set of newly developed calculation algorithms. The traditional parameters obtained from an arterial sample are the oxygen tension (pO2) and the hemoglobin oxygen saturation (sO2). Clinical examples illustrate that the pO2 and the sO2 even in combination may give misleading information. The new algorithm calculates three extra oxygen parameters. 1) The oxygen extraction tension, px, defined as the tension required to extract 2.3 mmol of oxygen per liter blood. It signals the mixed venous pO2 level on the assumption that the arterio-venous oxygen difference is normal (2.3 mmol/L). 2) The concentration of extractable oxygen, cx, defined as the concentration of oxygen extracted at a tension of 5.0 kPa. 3) The oxygen compensation factor, Qx, derived as (2.3 mmol/L)/cx. It may be interpreted as the increase in cardiac output necessary to maintain a normal mixed venous pO2 of 5 kPa. These three parameters indicate the oxygen availability of the blood and summarize important properties of the arterial blood in relation to oxygen supply of the tissues, including the arterial pO2, the 'active' hemoglobin concentration (equivalent to the oxygen capacity), and the hemoglobin oxygen affinity (p50). The set of data measured with the blood gas analyzer, e.g. the ABL300 combined with the data measured with the OSM3 contains much more information than is routinely utilized. This information is extracted and summarized by our calculation algorithm. Omitting the calculation of the extra oxygen parameters involves a risk of losing valuable information.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D005260 Female Females
D006706 Homeostasis The processes whereby the internal environment of an organism tends to remain balanced and stable. Autoregulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006863 Hydrogen-Ion Concentration The normality of a solution with respect to HYDROGEN ions; H+. It is related to acidity measurements in most cases by pH pH,Concentration, Hydrogen-Ion,Concentrations, Hydrogen-Ion,Hydrogen Ion Concentration,Hydrogen-Ion Concentrations

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