Effects of pulmonary flow heterogeneity on oxygen transport parameters in exercise.

Effects of pulmonary flow heterogeneity on oxygen transport parameters in exercise.
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DOI:
10.1016/j.resp.2018.10.004
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发表时间:
2019-03
影响因子:
2.3
通讯作者:
Secomb TW
Secomb TW
中科院分区:
医学4区
文献类型:
--
作者:
Roy TK;Secomb TW

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在静息常氧条件下,健康肺相对于氧需求具有充足的氧摄取能力,但在运动期间,增加的氧需求和利用变得越来越依赖于通气-灌注匹配。本文用一个数学模型来研究肺血流不均匀性对运动中肺氧摄取的影响,其特征是毛细血管血流的变异系数(CV)。该模型表明,任何水平的异质性高达CV为3是与观察到的水平的动脉氧分压在休息条件下是一致的,但这种高水平的异质性是不相容的运动过程中观察到的摄氧量的水平。如果一个正常的弥散能力被假定,最适合文献数据的动脉血氧含量的人在常氧和低氧条件下行使被发现具有相对较低的CV为0.48,这表明,局部流量调节机制,如缺氧性肺血管收缩发挥了重要作用,在运动期间的通气-灌注匹配。
Under resting normoxic conditions, the healthy lung has ample oxygen uptake capacity relative to oxygen demand, but during exercise, increased oxygen demand and utilization become increasingly dependent on ventilation-perfusion matching. A mathematical model is used to investigate the effect of pulmonary flow heterogeneity, as characterized by the coefficient of variation (CV) of capillary blood flow, on pulmonary oxygen uptake in exercise. The model reveals that any level of heterogeneity up to a CV of 3 is consistent with the observed level of arterial oxygen tension under resting conditions, but that such high levels of heterogeneity are incompatible with the levels of oxygen uptake observed during exercise. If a normal diffusing capacity is assumed, the best fit to literature data on arterial oxygen content of exercising humans under normoxic and hypoxic conditions is found with a relatively low CV of 0.48, suggesting that local flow regulation mechanisms such as hypoxic pulmonary vasoconstriction play an important role in ventilation-perfusion matching during exercise.
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