title: Is enough oxygen too much?
abstract: Human cells require O2 for their energy supply, and critical illness can threaten the efficient delivery of O2 in accordance with tissue metabolic needs. In the accompanying article, Martin and colleagues point out that hypoxia is a normal and well-tolerated stress during embryonic development. A better understanding of how fetal cells survive these conditions and how adult cells adapt to high altitude exposure may provide insight into how these mechanisms might be engaged in the treatment of hypoxemic patients. They suggest that 'permissive hypoxia' represents a therapeutic possibility. But before we turn down the inspired O2 levels we should consider the broader effects of hypoxia on tissue repair in critical illness.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Northwestern University, Feinberg School of Medicine, 310 E, Superior St, Morton Bldg 4-685, Chicago, IL 60611, USA. p-schumacker@northwestern.edu
authors.forename: Paul T
authors.initials: PT
authors.lastname: Schumacker
mesh_terms: D016638:Critical Illness; D006801:Humans; D000860:Hypoxia / Q000378:metabolism / Q000503:physiopathology* / Q000517:prevention & control; D010100:Oxygen / Q000378:metabolism; D010102:Oxygen Inhalation Therapy
chemical_list: D010100:Oxygen
references.citation: Proc Natl Acad Sci U S A. 1998 Sep 29;95(20):11715-20
references.pmid: 9751731
references.citation: Crit Care Med. 2005 Dec;33(12 Suppl):S423-5
references.pmid: 16340411
references.citation: Nature. 1997 Mar 27;386(6623):403-7
references.pmid: 9121557
references.citation: Cell. 2001 Oct 5;107(1):1-3
references.pmid: 11595178
references.citation: Novartis Found Symp. 2006;272:234-52; discussion 252-8, 274-9
references.pmid: 16686439
references.citation: Mol Cell Biol. 2009 Jul;29(13):3455-64
references.pmid: 19380482
references.citation: Cell Metab. 2005 Jun;1(6):401-8
references.pmid: 16054089
references.citation: Int J Radiat Oncol Biol Phys. 1989 Jul;17(1):91-9
references.pmid: 2745213
references.citation: Crit Care. 2010;14(4):315
references.pmid: 20727228