Arguments for revision of classification of hypoxic states

Abstract

Hypoxia always leads to dysfunction of organs and culminates in the fatal outcome. The principles of classification of the hypoxic states were formulated in 1930-s. The first successful cardiac transplantation posed the problem of dividing of circulatory cardiovascular hypoxia into two subdivisions: hypoxia associated with impaired cardiac contractility (cardiac insufficiency) and hypoxia resulting from vascular smooth muscle cell. Here we attempted to improve classification of hypoxic states on the basis of new medical achievements. The proposed classification considers the following hypoxic states: 1) exogenous hypoxia; 2) respiratory hypoxia; 3) hypoxia resulting from cardiac insufficiency; 4) hypoxia provoked by vascular smooth muscle dysfunction; 5) hemic hypoxia; 6) tissue hypoxia; and 7) combined hypoxia. There are specific and pathogenically substantiated methods for correction of all elements of the "hypoxic chain" that regulate tissue metabolism at the cellular and subcellular level both in the whole organism and in individual organs. These methods open new vistas in biology and medicine, in particular, in transplantology.