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Biomedical subjects

A H Goodman

Publications and source records attributed to A H Goodman.

At least 55 records · Page 3Linked to original sources

Role of resistance and exchange vessels in local microvascular control of skeletal muscle oxygenation in the dog.

The effects of reduction in perfusion pressure, arterial hypoxia, muscle contraction, and adrenergic stimulation on the hindlimb muscle circulation were studied. Under normal conditions (venous PO2 greater than or equal to 40 mm Hg), oxygen delivery to the muscle was maintained mainly by large increases in the capillary exchange capacity and the oxygen extraction ratio in accord with tissue demand following the application of the above stresses. The participation of the resistance vessels under these conditions was minimal. The prevailing venous oxygen tension then was reduced by several means and the response of vascular resistance and capillary exchange capacity to the same stresses was reexamined. At the lower prevailing venous PO2, the sensitivity of the resistance vessels to metabolic and hemodynamic disturbances was greatly increased. Consequently, blood flow autoregulation, functional hyperemia, and hypoxic hyperemia were more intense when venous oxygen tension was low. In contrast, the contribution of exchange capacity was diminished, probably owing to the fact that most of the capillaries already are open at low venous PO2. These data suggest that the locus of local microvascular control of muscle oxygenation shifts from the normally more sensitive precapillary sphincters to the proximal flow-controlling arterioles as the prevailing venous oxygen tension falls. Yet, although the relative contribution of the resistance and exchange vessels to intrinsic regulation of tissue oxygenation is related to the prevailing venous oxygen tension, the two compensatory mechanisms operating in concert maintain tissue PO2 above the critical level over a wide range of stresses.

Animals↗

Mean flow measurements in aortofemoral arterial reconstructions.

Eighty-seven limbs in 48 patients have been studied with an electromagnetic flow meter at the time of arterial reconstruction designed to restore blood flow from the aorta to the femoral artery system. The mean overall flow was 339 ml per minute. Blood flow in aneurysmal disease was significantly higher than that recorded in obstructive disease. Blood flow in arteries running into a fully patent femoral system was significantly higher than in those that ran only into the profunda. Age, sex, type of surgery and size of graft had no influence on the flow achieved. Reconstructions for rest pain or advanced trophic change produced flows of the same magnitude as reconstructions for intermittent claudication. The patient's weight correlated significantly with the intraoperative flow. The mean flow in the limbs of 28 patients in whom an accurate preoperative weight was known was 2-56 ml/100 gm/minute, taking the hind limb and hemi-pelvis as 25% of the body weight. This is an acceptably "normal" value. A flow of less than 100 ml per minute in an aortoiliac reconstruction was found to be not likely to result in long-term patency.

Aneurysm↗

Metabolic models of microcirculatory regulation.

The functions and integrity of body tissues are critically dependent on an adequate oxygen supply. Because the transport of oxygen to the cells is intimately linked to the microcirculation, the concept of microcirculation-metabolism coupling has received much attention. In essence, the metabolic theory of intrinsic control of the microcirculation states that microvascular tone is locally modulated to maintain adequate oxygen levels in the parenchymal cells. We propose a two-component control system for the regulation of tissue O2 delivery in accordance with metabolic needs. A precapillary sphincter control mechanism maintains tissue PO2 by governing the number of perfused capillaries. Functional capillary density in turn determines surface area available for diffusion and capillary-to-cell diffusion distance. On the other hand, the arteriolar control system modulates local blood flow in accordance with parenchymal O2 utilization and thereby minimizes changes in capillary PO2 when the O2 availability/demand ratio is decreased. We propose that the precapillary sphincters are more sensitive to changes in tissue PO2 than are the flow-regulating arterioles. Consequently, for mild stresses, adequate tissue oxygenation is maintained mainly by precapillary sphincter control of diffusion parameters without the need for changes in blood flow. However, as metabolic stresses become greater, blood flow regulation becomes the dominant factor in the control of tissue O2 delivery. Thus, by working in concert, the local mechanisms regulating microvascular resistance and effective capillary density provide a wide margin of safety against the development of cellular hypoxia.

Capillaries↗