The Development and Use of Equations for Predicting the Limits on the Rates of Oxygen Supply to the Cells of Living Tissues and Organs

Knisely, Melvin H.; Reneau, Daniel D.; Bruley, Duane F.

doi:10.1177/0003319769020011s01

Cited by 20 publications

(10 citation statements)

References 75 publications

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“…In previous work (Bicher & Beemer, 1967), we suggested that intravascular red cell aggregation may be a factor in the induction of anoxic myocardial damage. Recently, Knisely, Reneau & Bruley (1969) developed a mathematical equation which predicted the development of multiple minute areas of anoxia in brain tissue under this condition.…”

Section: Introductionmentioning

confidence: 99%

Effect of microcirculation changes on brain tissue oxygenation

Bicher¹,

Bruley²,

Knisely³

et al. 1971

The Journal of Physiology

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1. A new, 2 μ tip, oxygen micro‐electrode and a constantly circulated Beckman oxygen gas analyser were used to measure tissue and blood PO2 in anaesthetized, curarized cats under positive pressure breathing. As a parameter for the ability of the circulation to oxygenate tissue, the ‘reoxygenation time’ (defined as the time required to reach the previous PO2 level after a short period of anoxic anoxia) was determined on blood and cerebral cortex. 2. First, it was found that haemorrhage (from 15–25 c.c./kg) alone or haemorrhage combined with sludging of the blood (by the I.V. administration of high molecular weight Dextran, 1 g/kg) markedly diminished PO2 levels in blood and tissue. 3. Further, the reoxygenation time was significantly affected by these procedures. Sludging markedly prolonged the reoxygenation time, an effect counteracted by the use of an anti‐adhesive drug breaking up the red cell aggregates. 4. Bleeding prolonged the reoxygenation time up to four times that found in the same animals previous to the bleeding.

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Section: Introductionmentioning

confidence: 99%

Effect of microcirculation changes on brain tissue oxygenation

Bicher¹,

Bruley²,

Knisely³

et al. 1971

The Journal of Physiology

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“…As previously pointed out, the blood donors studied by Knisely et all° and Bloch 13 remained alert and did not lose consciousness which indicates that the volume of blood drawn could not have been enough to reduce flow through central nervous system vessels significantly.&dquo;, 12 Further, in the spleen and liver the responses are probably different and more complicated. In response to severe hemorrhage in mammals we can expect the spleen to eject concentrated blood cells (reviewed by Kniselyl9) and the liver to eject stored stationary or moving blood.…”

Section: Discussionmentioning

confidence: 90%

“…This indicates inescapably that the amounts of blood withdrawn, although sufficient to initiate spasms of vessels in some tissues, were not enough to initiate significant reductions of blood flow through the capillaries of the central nervous system.11, 12 Bloch,13 who gives a good description of the same vertically aimed Leitz stereoscopic microscope, reported on observations of conjunctival vessels of 200 donors who were bled rapidly: &dquo;Five hundred cc. None of the above unanesthetized human subjects lost consciousness or even showed signs of mental confusion.…”

mentioning

confidence: 99%

Separation of Shock Types

et al. 1970

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It is now commonly believed that in many patients in circulatory shock there is &dquo;inadequate perfusion of blood&dquo; through the tissues of the various organs of the body. The direct causes of inadequate perfusion are different in different types of shock, and several sets of causes can be operating in any one patient-' It has been shown2 that three types of circulatory shock can experimentally be separated from each other, i.e., (a) pure hemorrhagic shock with minimal trauma from (b) traumatic crushing shock with minimal hemorrhage, from (c) &dquo;reservoir retention&dquo; shock. Following hemorrhage with minimal trauma there are prolonged contractions of arteries, capillaries and veins. Following crushing trauma with minimal hemorrhage, there is a precipitation and agglutination of the blood into a circulating sludge. Following extensive burns, in man and other mammals there is a severe intravascular agglutination of all the circulating blood (reviewed by Knisely3) . In reservoir retention shock in several species including man,2 the outlet sphincter valves of the liver (reviewed by Knisely et a1.4) close, and in consequence the liver, portal vein bed and tributaries store so much blood that not enough is left to fill the rest of the circulatory system and maintain venous return and circulation. (For basic physiology, see Krogh and Lindhard5; Krogh6. 7; Knisely et al.8 ; Thomas and Essex9; and Knisely et al.4) The main purpose of this paper is to show that in two different types of shock, hypovolemic and septic, the inadequate perfusion of tissue is directly caused by two separate mechanisms and that, in consequence, separate (though perhaps in practice, overlapping) types of treatment are needed for each. The paper summarizes certain historical studies and then presents findings from our own animal laboratories and from our clinical Shock Trauma Unit.Experiynental bleeding of human beings: In 1947 Knisely et al. reported that healthy people (blood donors) responded to blood loss by contraction of arterioles, capillaries, and venules.l° In order to see if controlled hemorrhage does initiate visible spasms of conjunctival vessels, the blood and vessels of 34 blood donors, unanesthetized, unoperated relatives and friends of hospital patients who volunteered to donate blood, were studied before, during, and for 30 to 60 minutes immediately after each donated blood From the

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“…The possibility has not been ruled out that ethanol's actions are, in part at least, associated with a reduction of microcirculation (MOSKOW et al, 1968;KNISELY et al, 1969;PENNINGTON and KNISELY, 1973). Data exist to support a direct relationship; there have been no confirming studies of which this writer is aware.…”

Section: Alterations In Microcirculationmentioning

confidence: 91%

The Pharmacology of Sedative/Hypnotics, Alcohol, and Anesthetics: Sites and Mechanisms of Action

Smith¹

1977

Drug Addiction I

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The Development and Use of Equations for Predicting the Limits on the Rates of Oxygen Supply to the Cells of Living Tissues and Organs

Cited by 20 publications

References 75 publications

Effect of microcirculation changes on brain tissue oxygenation

Effect of microcirculation changes on brain tissue oxygenation

Separation of Shock Types

The Pharmacology of Sedative/Hypnotics, Alcohol, and Anesthetics: Sites and Mechanisms of Action

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