Oxygen delivery and consumption

Oxygen delivery and consumption

Authors
Ilene M Rosen, MD, MSCE
Scott Manaker, MD, PhD
Section Editor
Polly E Parsons, MD
Deputy Editor
Helen Hollingsworth, MD
Disclosures
All topics are updated as new evidence becomes available and our peer review process is
complete.
Literature review current through: Oct 2012. | This topic last updated: May 15, 2012.
INTRODUCTION Inspired oxygen from the environment moves across the alveolar-capillary
membrane into the blood. Most of the oxygen binds to hemoglobin in red blood cells, although a
small amount dissolves into the plasma. The oxygen is then transported from the lungs to the
peripheral tissues, where it is removed from the blood and used to fuel aerobic cellular
metabolism. This process can be conceptualized as three steps: oxygenation, oxygen delivery,
and oxygen consumption. In this topic review, oxygen delivery and consumption are reviewed.
Oxygenation is discussed separately. (See "Oxygenation and mechanisms of hypoxemia".)
DEFINITIONS
Oxygen content The arterial oxygen content (CaO
2
) is the amount of oxygen bound to
hemoglobin plus the amount of oxygen dissolved in arterial blood:
CaO
2
(mL O
2
/dL) = (1.34 x hemoglobin concentration x SaO
2
) + (0.0031 x PaO
2
)
where SaO
2
is the arterial oxyhemoglobin saturation and PaO
2
is the arterial oxygen tension.
Normal CaO
2
is approximately 20 mL O
2
/dL.
Similarly, the mixed venous blood oxygen content (CvO
2
) is the amount of oxygen bound to
hemoglobin plus the amount of oxygen dissolved in mixed venous blood:
CvO
2
(mL O
2
/dL) = (1.34 x hemoglobin concentration x SvO
2
) + (0.0031 x PvO
2
)
where SvO
2
is the mixed venous oxyhemoglobin saturation and PvO
2
is the mixed venous
oxygen tension. Normal CvO
2
is approximately 15 mL O
2
/dL. Mixed venous blood is drawn
from the right atrium. Peripheral venous blood should not be substituted because it tends to
overestimate venous oxygen content.
Oxygen delivery Oxygen delivery (DO
2
) is the rate at which oxygen is transported from the
lungs to the microcirculation:
DO
2
(mL/min) = Q x CaO
2

where Q is the cardiac output. Normal DO
2
is approximately 1000 mL/min. Normal DO
2
is
approximately 500 mL/min/m
2
if cardiac index is substituted for cardiac output.