Normal cardiac output, oxygen delivery and oxygen extraction

Abstract

The total amount of blood flow circulating through the heart, lungs and all the tissues of the body represents the cardiac output. Most individual tissues determine their own flow in proportion to their metabolic rate. The skin is a notable exception where the priority is thermal rather than metabolic. Renal blood flow and metabolic rate are related but plasma flow determines metabolic rate rather than metabolic rate determining blood flow. 1 Brain, heart, skeletal muscle and the splanchnic area all vary their blood flows according to local tissue metabolic rate. Summation of peripheral blood flows constitutes venous return and hence cardiac output. Cardiac output is therefore, largely, determined by the metabolic rate of the peripheral tissues; the heart 'from a flow standpoint, plays a "permissive" role and does not regulate its own output'. 2 This peripheral tissue, largely metabolic, determination of cardiac output has been known for many years. 3,4 © 2008 Springer Science+Business Media, LLC.