The oxyhaemoglobin dissociation curve in XXXX .

@entity1 @entity6297 @entity2451 @entity2944 @entity26 @entity3124
OBJECTIVE: To review the status of haemoglobin- @entity26 affinity in @entity3124 and investigate the potential to improve gas exchange, tissue oxygenation and outcome by manipulations of the oxyhaemoglobin dissociation curve. DATA SOURCES: Articles and published peer-review abstracts. SUMMARY OF REVIEW: The @entity2451 of a species is determined by natural selection according to animal size, tissue metabolic requirements and ambient @entity26 tension. In right to left shunting mathematical modeling indicates that an increased @entity2451 defends capillary oxygenation, the one exception being sustained @entity2944 . Increasing the @entity2451 should also be protective in tissue ischaemia, and this is supported by modeling and experimental evidence. Most studies of critically ill @entity1 have indicated reduced @entity6297 concentrations. This is probably due to acidaemia, and the in vivo @entity2451 is likely to be normal despite low @entity6297 levels. It may soon be possible to achieve significant @entity2451 elevations without potentially harmful manipulations of acid-base balance or hazardous drug therapy. CONCLUSIONS: Despite encouraging theoretical and experimental data, it is not known whether manipulations of the @entity2451 in @entity3124 can improve gas exchange and tissue oxygenation or improve outcome. The status of the @entity2451 may warrant more routine quantification and consideration along with the traditional determinants of tissue @entity26 availability.
