Lecture

Oxygen Pressure field Theory, The Krogh Cylinder and Long-Term Extra corporeal Perfusion: An Old Concept Provides New Insight

¹ Department of Surgery, The Children's Mercy Hospital, Kansas City, Missouri
² The School of Cardiopulmonary Perfusion, The Heart Institute, St. Vincent Hospital and Medical Center, Portland, Oregon

^* Address correspondence to: Gary E. Grist, BS, RN, CCP, Operating Room, The Children's Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108

Abstract

This article describes oxygen pressure field theory and its relevance to the application of long-term perfusion support. Prolonged applications of extracorporeal support for cardiac or pulmonary failure require a more perceptive understanding of perfusion and how it works over a period of days or weeks. The key to this understanding lies in the concepts of the Krogh tissue cylinder, the lethal corner and perfused capillary density. The interrelationships of these concepts define the microvascular redistribution system and its need to remain in balance in order to maintain homeostasis. An imbalance in any of the aspects described could result in tissue damage and eventual death.

Perfusionists attempting to perform long-term extracorporeal support can improve the odds for patient survival with a clear understanding of oxygen pressure field theory and its associated concepts. By maintaining a balance in the microvascular redistribution system, the perfusionist not only keeps the patient alive, but creates an environment where healing can occur over a period of days or weeks.