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SUMMARY1. Renal blood flow, local tissue perfusion and blood oxygen content are the major determinants of oxygen delivery to kidney tissue. Arterial pressure and segmental vascular resistance influence kidney oxygen consumption through effects on glomerular filtration rate and sodium reabsorption.2. Diffusive shunting of oxygen from arteries to veins in the cortex and from descending to ascending vasa recta in the medulla limits oxygen delivery to renal tissue. Oxygen shunting depends on the vascular network, renal haemodynamics and kidney oxygen consumption. Consequently, the impact of changes in renal haemodynamics on tissue oxygenation cannot necessarily be predicted intuitively and, instead, requires the integrative approach offered by computational modelling and multiple measuring modalities.3. Tissue hypoxia is a hallmark of acute kidney injury (AKI) arising from multiple initiating insults, including ischaemia-reperfusion injury, radiocontrast administration, cardiopulmonary bypass surgery, shock and sepsis. Its pathophysiology is defined by inflammation and/or ischaemia resulting in alterations in renal tissue oxygenation, nitric oxide bioavailability and oxygen radical homeostasis. This sequence of events appears to cause renal microcirculatory dysfunction, which may then be exacerbated by the inappropriate use of therapies common in peri-operative medicine, such as fluid resuscitation.4. The development of new ways to prevent and treat AKI requires an integrative approach that considers not just the molecular mechanisms underlying failure of filtration and tissue damage, but also the contribution of haemodynamic factors that determine kidney oxygenation. The development of bedside monitors allowing continuous surveillance of renal haemodynamics, oxygenation and function should facilitate better prevention, detection and treatment of AKI.

The kidney is faced with unique challenges for oxygen regulation, both because its function requires that perfusion greatly exceeds that required to meet metabolic demand and because vascular control in the kidney is dominated by mechanisms that regulate glomerular filtration and tubular reabsorption. Because tubular sodium reabsorption accounts for most oxygen consumption (Vo2) in the kidney, renal Vo2 varies with glomerular filtration rate. This provides an intrinsic mechanism to match changes in oxygen delivery due to changes in renal blood flow (RBF) with changes in oxygen demand. Renal Vo2 is low relative to supply of oxygen, but diffusional arterial-to-venous (AV) oxygen shunting provides a mechanism by which oxygen superfluous to metabolic demand can bypass the renal microcirculation. This mechanism prevents development of tissue hyperoxia and subsequent tissue oxidation that would otherwise result from the mismatch between renal Vo2 and RBF. Recent evidence suggests that RBF-dependent changes in AV oxygen shunting may also help maintain stable tissue oxygen tension when RBF changes within the physiological range. However, AV oxygen shunting also renders the kidney susceptible to hypoxia. Given that tissue hypoxia is a hallmark of both acute renal injury and chronic renal disease, understanding the causes of tissue hypoxia is of great clinical importance. The simplistic paradigm of oxygenation depending only on the balance between local perfusion and Vo2 is inadequate to achieve this goal. To fully understand the control of renal oxygenation, we must consider a triad of factors that regulate intrarenal oxygenation: local perfusion, local Vo2, and AV oxygen shunting.

The public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 14. ABSTRACT The mechanics of uncemented soft sediments during bubble growth are not widely understood and no rheological model has found wide acceptance. We offer definitive evidence on the mode of bubble formation in the form of X-ray computed tomographic images and comparison with theory. Natural and injected bubbles in muddy cohesive sediments are shown to be highly eccentric oblate spheroids (disks) that grow either by fracturing the sediment or by reopening preexisting fractures. In contrast, bubbles in soft sandy sediment tend to be spherical, suggesting that sand acts fluidly or plastically in response to growth stresses. We also present bubble-rise results from gelatin, a mechanically similar but transparent medium, that suggest that initial rise is also accomplished ABSTRACT idization, e.g., gravity flows, during some natThe mechanics of uncemented soft sediments during bubble growth are not widely ural disturbances have suggested that such understood and no rheological model has found wide acceptance. We offer definitive ev-sediments can act fluidly or plastically in reidence on the mode of bubble formation in the form of X-ray computed tomographic sponse to stress. Past mechanical models of images and comparison with theory. Natural and injected bubbles in muddy cohesive bubbles in these sediments have visualized the sediments are shown to be highly eccentric oblate spheroids (disks) that grow either by bubbles as essentially spherical (e.g., Wheeler, fracturing the sediment or by reopening preexisting fractures. In contrast, bubbles in soft 1988; Sills et al., 1991), with the implication, sandy sediment tend to be spherical, suggesting that sand acts fluidly or plastically in intentional or not, that the surrounding mediresponse to growth stresses. We also present bubble-rise results from gelatin, a mechan-um reacts fluidly or plastically to their growth ically similar but transparent medium, that suggest that initial rise is also accomplished and rise. Scientists and engineers have develby fracture. Given that muddy sediments are elastic and yield by fracture, it becomes oped an impressive understanding of bubble much easier to explain physically related phenomena such as seafloor pockmark forma-growth in fluids, and a vast literature covers tion, animal burrowing, and gas buildup during methane hydrate melting.the topic (e.g., Clift et al., 1978; Lohse, 2003). However, we show here that muddy sediment Keywords: bubbles, mud, fracture, methane.does not respond mechanically either a...

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