Intro
A talk by Knut Kvernebo at The Big Sick 2023 conference. Kindly shared with permission.
See the TBS23 landing page for the programme and full set of talks.
Synopsis
The most important functions of human physiology are related to delivery of oxygen – the molecule that created life – to all 10^14 cells of the body. O2 is uploaded to the erythrocytes in the lungs, transported with the heart as the driving force and delivered to the tissues from the capillaries. Clinical medicine has biomarkers for lung function (e.g. SaO2), heart function (e.g. assessments of cardiac output), but we lack direct biomarkers of oxygen delivery. Since the O2 molecule has poor diffusion capacity in human tissues, all cells must be located near to a perfuses capillary. The maximal diffusion distance (called a Krogh diameter) is in the range of ≈150 microns. To achieve optimal distribution of well oxygenated cardiac output between and within organs, evolution has developed incredibly complex mechanisms. Several disease conditions can stretch these regulatory mechanisms and cause microvascular dysregulation, tissue hypoxia and finally cell death – often in spite of adequate lung and heart function – i.e. lack of coherence between central- and microvascular hemodynamics. In clinical medicine serum lactate levels are used as an indication of cell oxygenation, but the problem is that lactate concentrations in tissues may be high despite serum lactate levels within reference levels.
VIDEO
Until we have final edits ready the video below is straight from the livestream. Expect a few audio issues and other glitches here and there.
SLIDES
Speaker
Title/work
Prof em Institute Clinical Medicine, University of Oslo + CMO ODI Medical AS
Bio
Professor Knut Kvernebo is a certified vascular and cardio-thoracic surgeon. He is a professor of cardio-thoracic surgery at the University of Oslo since 25 years. His main research interests are microvascular hemodynamics and clinical microcirculation (>100 scientific papers; 10 international book chapters; supervised 15 PhD projects). He is also the founder and CMO of ODI medical AS (a company developing technologies for bedside microvascular examinations). He has ongoing research collaborations with Massachusetts General Hospital, Cleveland Clinic, NYU Langone, Flinders University, Australia, as well as the University College of London.
Links
Email: [email protected]
COI declared
KK is founder, shareholder and CMO of ODI Medical AS
References / Further reading
Kvernebo K. Microcirculation and Tissue Perfusion Assessments for Complex Cardiovascular Disease Care. In «Advances in Cardiovascular Technology: New Devices and Concepts». Elsevier 2022. (ISBN: 978-0-323-95878-3)
Scandinavian paediatric anaesthetist / intensivist.
PHARM, ED, OR, ICU.
Digital MedEd
Co-founder scanFOAM.org
Co-organiser CphCC & TBS-Zermatt (aka The Big Sick)
Medical lead REPEL (resilience in pediatric emergency life support)
Web dev SSAI.info
