concepts in hypoxia reborn概念在缺氧重生.pdfVIP

Martin et al. Critical Care 2010, 14:315 /content/14/4/315 V I E W P O I N T Concepts in hypoxia reborn 1,2 1 1,3 2,4 Daniel S Martin* , Maryam Khosravi , Mike PW Grocott and Michael G Mythen in utero’ and proposed that to survive the hypoxic uterine Abstract environ ment the fetus must develop elaborate physio- The human fetus develops in a profoundly hypoxic logical strategies comparable to those seen in climbers environment. Thus, the foundations of our physiology ascending the great Himalayan peaks. are built in the most hypoxic conditions that we are In 2007, four climbers descending from the summit of ever likely to experience: the womb. This magnitude Mount Everest (8,848 meters) took arterial blood gases of exposure to hypoxia in utero is rarely experienced from one another at 8,400 meters above sea level. h eir in adult life, with few exceptions, including severe mean arterial partial pressure of oxygen (PaO2) was pathophysiology in critical illness and environmental 3.28  kPa (24.6 mm Hg) with a mean calculated arterial hypobaric hypoxia at high altitude. Indeed, the lowest oxygen saturation (SaO2) of 54% while they rested with- recorded levels of arterial oxygen in adult humans out supplemental oxygen [3]. Among this group, one are similar to those of a fetus and were recorded just individ ual had a PaO2 of 2.55  kPa (19