Wagners curves for explanation pathophysiology of oxygen delivery

Wagner‘s curves for explanation pathophysiology of oxygen delivery (idea of serious simulation game for medical education)

1 torr The rate of diffusion of oxygen, ml / min Pv. O 2 Diffusion (at critical mitochondrial PO 2 = 1 torr) 4000 Difusing Capacity 3000 2000 1000 0 0 10 20 30 40 50 60 70 Venous PO 2, mm. Hg 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] VO 2 = DO 2=Ca. O 2 x Q 4000 Ca. O 2=0 ven. flow = 0 art. flow 100% extraction from arterial blood VO 2 = art. flow 3000 2000 0% extraction from arterial blood ven. flow = art. flow 1000 VO 2 = 0 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 Ca. O 2 90 VO 2 = 0 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease 3000 Increased affinity of Hb for oxygen 2000 In o cre f H ase b d fo af r o fin xy ity ge n 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

4000 Oxygen Delivery decrease 3000 p 2000 Perfusion decrease p n sio fu er Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] erf u sio n 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Pa. O 2 decrease or Hb concentration decrease 4000 3000 Ca. O 2 decrease 2000 Oxygen Delivery decrease 2 a. O C 1000 Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 0 0 10 20 30 40 50 60 crit. Pv. O 2 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 VO 2 max 3000 VO 2 2000 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] Decrease in diffusion capacity in muscles 4000 VO 2 max 3000 VO 2 max VO 2 2000 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease VO 2 max 3000 Increased affinity of Hb for oxygen VO 2 2000 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease VO 2 max 3000 Increased affinity of Hb for oxygen VO 2 2000 In o cre f H ase b d fo af r o fin xy ity ge n 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease 3000 VO 2 max crit. Pv. O 2 VO 2 2000 Perfusion decrease Q 1>Q 2 >Q 3 Q 1 Q 3 Q 2 1000 0 0 10 20 30 critical Pv. O 2 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease 3000 crit. Pv. O 2 VO 2 2000 Perfusion decrease Q 1>Q 2 >Q 3 1000 Q 3 0 0 10 20 30 critical Pv. O 2 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease 3000 crit. Pv. O 2 VO 2 2000 Perfusion decrease Q 1>Q 2 >Q 3 Q 1 Q 3 Q 2 1000 0 0 10 20 30 critical Pv. O 2 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 4000 Oxygen Delivery decrease 3000 crit. Pv. O 2 VO 2 2000 Perfusion decrease 1000 0 0 10 20 30 critical Pv. O 2 40 50 60 Venous PO 2, mm. Hg 70 80 90 100

Pa. O 2 decrease or Hb concentration decrease 4000 VO 2 max 3000 VO 2 max Ca. O 2 decrease VO 2 2000 VO 2 max Oxygen Delivery decrease 2 a. O C 1000 Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 0 0 10 20 30 40 50 60 crit. Pv. O 2 Venous PO 2, mm. Hg 70 80 90 100

Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] Pa. O 2 decrease or Hb concentration decrease 4000 VO 2 max 3000 VO 2 max Ca. O 2 decrease VO 2 2000 VO 2 max Oxygen Delivery decrease 1000 0 0 10 20 30 40 50 60 crit. Pv. O 2 Venous PO 2, mm. Hg 70 80 90 100

Trained High maximum metabolic capacity 4000 VO 2 max Untrained Low maximum metabolic capacity 3000 2000 train unt ed rain ed Oxygen consumption (VO 2) ml / min Fick principle: VO 2 = Q x [Ca. O 2 – Cv. O 2] 1000 0 0 10 20 30 40 50 60 Venous PO 2, mm. Hg 70 80 90 100