Mathematical model for the estimation of hemodynamic and oxygenation variables by tissue spectroscopy.

This article presents a quasistatic, compartmental model of tissue-level hemodynamics and oxygenation that leads to a set of formulas, which is suitable to calculate important physiological variables from the mean tissue concentration and saturation of hemoglobin, measured by tissue spectroscopy. Dimensioned quantities are represented relative to their baseline value in the equations (relative value = perturbed/baseline). All model parameters are non-dimensional. The model is based and extends on a number of previous works: previous models of similar aim and scope are consolidated, and every critical assumptions and approximations are treated explicitly; extensions include for example the incorporation of the Fahraeus-effect and the separate estimation of the volume changes of the arterial and the venous compartments. The information content of spectroscopic data alone is shown to be valuable, but limited: the relative venous volume, the oxygen extraction fraction and the relative cellulovascular coupling (defined as the ratio of blood flow and oxygen consumption) can be calculated from these data, if the alterations in arterial blood volume are negligible. The number of variables estimated by the derived formulas can be increased if local blood flow is measured simultaneously: in this case, the relative arterial and venous volume and resistance, the oxygen extraction fraction, and the relative oxygen consumption can be determined. Given that this model considers arterial blood pressure, saturation and hematocrit as its inputs, when measured, the model becomes applicable in such conditions as hyper- or hypotension, hypoxic hypoxia, hemodilution and hemorrhage, where these variables do change. The estimation of the changes in arterial resistance can be applied to estimate the extent of an autoregulatory response.