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Semin Respir Crit Care Med 2023; 44(05): 594-611
DOI: 10.1055/s-0043-1770061
Review Article

Tissue Perfusion and Diffusion and Cellular Respiration: Transport and Utilization of Oxygen

Connie C. W. Hsia
1   Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations Funding This study was supported by the National Heart, Lung and Blood Institute grant (grant number: R01 HL157533).
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Abstract

This article provides an overview of the journey of inspired oxygen after its uptake across the alveolar–capillary interface, and the interplay among tissue perfusion, diffusion, and cellular respiration in the transport and utilization of oxygen. The critical interactions between oxygen and its facilitative carriers (hemoglobin in red blood cells and myoglobin in muscle cells), and with other respiratory and vasoactive molecules (carbon dioxide, nitric oxide, and carbon monoxide), are emphasized to illustrate how this versatile system dynamically optimizes regional convective transport and diffusive gas exchange. The rates of reciprocal gas exchange in the lung and the periphery must be well-matched and sufficient for meeting the range of energy demands from rest to maximal stress but not excessive as to become toxic. The mobile red blood cells play a vital role in matching tissue perfusion and gas exchange by dynamically regulating the controlled uptake of oxygen and communicating regional metabolic signals across different organs. Intracellular oxygen diffusion and facilitation via myoglobin into the mitochondria, and utilization via electron transport chain and oxidative phosphorylation, are summarized. Physiological and pathophysiological adaptations are briefly described. Dysfunction of any component across this integrated system affects all other components and elicits corresponding structural and functional adaptation aimed at matching the capacities across the entire system and restoring equilibrium under normal and pathological conditions.

Keywords

oxygen - hemoglobin - allosterism - myoglobin - electron transport - oxidative phosphorylation - mitochondrial coupling


Publication History

Article published online:
04 August 2023

© 2023. Thieme. All rights reserved.

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