Analysis of the critical determinants of renal medullary oxygenation.
Analysis of the critical determinants of renal medullary oxygenation.
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肾髓质氧合的关键决定因素分析。
DOI：
10.1152/ajprenal.00315.2019
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
David W. Smith
中科院分区：
文献类型：
--
作者：
Chang;B. Gardiner;R. Evans;David W. Smith
我们以前开发了一个三维计算模型的氧气运输在肾髓质。在本研究中，我们采用该模型来量化肾髓质氧合对其四个主要已知决定因素的敏感性：髓质血流量（MBF），髓质耗氧率（VO2，M），血液中的血红蛋白浓度（Hb）和肾灌注压（RPP）。我们还研究了在心肺转流（CPB）过程中，在特定条件下的髓氧合，通过输注等渗盐水进行细胞外液容量扩张，以及血液稀释。在基线（正常）条件下，整个肾髓质的平均髓质组织PO2预测值约为30 mmHg。外髓质（OM）中束间区域的周边被确定为肾髓质中缺氧最严重的区域，这表明模型预测在定性上是准确的。延髓氧合对RPP的变化最敏感，其次是Hb、MBF和VO2、M。髓氧合也变得敏感的促缺氧的变化，在其他参数，导致更大的下降，在髓组织PO2时，多个参数同时改变。与基线状态相比，水肿未引起髓质氧合的显著变化，而容量扩张导致内髓质（IM）组织PO2大幅增加（约15 mmHg）。在CPB条件下，由于血液稀释，肾髓质变得严重缺氧，三分之一的OSOM组织的PO2小于5 mmHg。
We previously developed a three-dimensional computational model of oxygen transport in the renal medulla. In the present study, we employed this model to quantify the sensitivity of renal medullary oxygenation to four of its major known determinants: medullary blood flow (MBF), medullary oxygen consumption rate (VO2,M), hemoglobin concentration in the blood (Hb), and renal perfusion pressure (RPP). We also examined medullary oxygenation under special conditions of hydropenia, extracellular fluid volume expansion by infusion of isotonic saline, and hemodilution during cardiopulmonary bypass (CPB). Under baseline (normal) conditions, the average medullary tissue PO2 predicted for the whole renal medulla was ~30 mmHg. The periphery of the interbundle region in the outer medulla (OM) was identified as the most hypoxic region in the renal medulla, which demonstrates that the model prediction is qualitatively accurate. Medullary oxygenation was most sensitive to changes in RPP followed by Hb, MBF and VO2,M, in that order. The medullary oxygenation also became sensitized by pro-hypoxic changes in other parameters, leading to a greater fall in the medullary tissue PO2 when multiple parameters changed simultaneously. Hydropenia did not induce a significant change in medullary oxygenation compared to the baseline state, while volume expansion resulted in a large increase in the inner medulla (IM) tissue PO2 (by ~15 mmHg). Under conditions of CPB, the renal medulla became severely hypoxic, due to hemodilution, with one-third of the OSOM tissue having a PO2 of less than 5 mmHg.
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DOI：
10.1152/ajpregu.1996.270.6.r1257
发表时间：
1996
期刊：
The American journal of physiology.
影响因子：
--
作者：
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DOI：
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发表时间：
2006-06-01
影响因子：
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