The Lancet • Saturday 19 September 1964 COMPARATIVE PHYSIOLOGY OF OXYGEN TRANSPORT JON MAMMALS* Heinz Bartels M.D. Tubingen PROFESSOR OF APPLIED PHYSIOLOGY, UNIVERSITY OF TUBINGEN Children can ask questions that place adults in quite s predicament. Such as: " Why are there elephants ? ", or " Why are mice so small ? " Examined more closely. these questions are not so stupid as we are at first inclined to suppose. Children have an unspoilt capacity for wonder—the ©avaaleiv of Epicurus—which adults lose iS too soon as their minds become saturated with facts. Another question that might be asked, not by a child 3u: by an adult who is childish enough, concerns the weight at birth of various mammals. Fig. 1 shows that weight at birth tends to be related to the length of gestation. Nevertheless, there must be considerable differences in the rate of fcetal growth; for after the same gestation period i newborn hippopotamus weighs fifty times as much as i newborn chimpanzee. Between seals and whales the difference is even greater. After almost the same gestation period, a newborn whale -s about two hundred times heavier than a newborn seal, tet the life of all of these animals begins with two cells, which do not vary significantly in size from mammal to •aammal (Linzbach 1955). In fig. 2. constructed by Huggett and Widdas (1951), the comparative differences O fcetal growth-rate are made clear. A modern philosopher has said: " It is an important and necessary indication of intelligence to know just what questions one judiciously should ask." The reason why *"«- may think the question " Why are there elephants ? " BW particularly intelligent is that we cannot conceive an •-aswer for it. Certainly I am not going to provide one. Instead, I -^all modify the question and ask: " How is it possible *«*» elephants and mice both live in the same environ ment ? ". Both are mammals, and very similar in structure and function; yet the intensity of their cellular metabolism fied if, according to the law of diniinishing metabolism (Zeuthen 1953, Lehmann 1956), the cells of a shrew require, on the average, a hundred times more oxygen (per gramme of tissue) than the cells of an elephant ? A corres ponding increase in the size of heart and lungs is unthink able; reckoning 1 litre as 1 kg., the lung volume alone represents about 8% of the body-weight—which makes a hundredfold increase impossible. The geometrically similar structure of mammals reflects itself in a fairly constant relation between lung volume and body-weight as graphically plotted (fig. 4) from the work of Tenney and Remmers (1963). Since the organs which transport oxygen through the body do not show any large adaptations of structure enabling them to cope with more intense metabolism, we must look for adaptations of function. If the differences are functional, we should expect to find that lung ventila tion and cellular blood-supply are proportional not to the body-weight but to the intensity of the metabolism. As lung capacity cannot be expanded sufficiently to meet the metabolic demand for oxygen, we should expect to find the rate of respiration increased. And in fact we do. As fig. 5 shows, the respiration-rate increases in direct propor tion to the metabolic rate; from which it follows that ventilation increases with increasing metabolism. ^•cs to the second power and their body-weight to the 7*k (ng- 3) power. How can such very different metabolic aemands be satisfied with the same son of lungs and respiratory organs ? I shall attempt to find an explanation by examining the Process of oxygen transport in these animals from the air 10 the body cells. Most mammals live in an environment which offers theni oxygen at tensions from 120 to 150 mm. Hg. A Pressure gradient between the oxygen tension of the ac*nosphere and that of the body cells allows oxygen to Pjss from the atmosphere to the cells enters withoutthe expenditure °t energy—so long as enough oxygen lungs and *j*-ansported by the circulating blood to xhe capillaries. ^tow can the oxygen requirements of the cells be satisPfcial lecture given on invitation of the University of London to April, 1964, at St. Mary's Medical School, W.2. ■£.7360 GESTATION PERIOD (days ) Fig. 1 —Birthweight in mammals as a function of gestation period. SEPTEMBER 19, 1964 ORIGINAL ARTICLES ventilation of various animals yields some interesting information. The work of Agostoni m n a c " m . i . . * . -■ * . - • , . . * * * ' • « . j i • ? Whale 330 390 takes five breaths two hundred, mear fluctuation in alveolar as well "as in arterST" ter-" - ~"- ■--■■--■ tic the size of the animal, and the greater fluctuation. alveolar zas concenrrarinn i<* h**fFV>r-»r* k~ i Hipp op ot cuni/s Rhinoceros (Red deer)- 12 \ ! Uon'/PIg aw ^Rot-deer • Puma /• Macacus -7*~ Chimpanzee ' "Mandrill 1lg^- - Moschus Uistiti toat , ou 120 180 2 40 300 360 420 480 540 mcreased residual capacity. To achieve their greater respiratory ventilation small animals must perform more work in breathi** per gramme of body-weight (Crosfill and Widd? combe 1961). But, as the entire metabolic proce* is more intense in small animals, they do not spend any greater proportion of their energy on respiratorneeds. Thus we see that the varying oxygen requirement! of large and small animals, with similar lung capacitv are served by differences in ventilation. The qu^ tion now arises whether the increase in ventilation of the lung is in fact related to increased oxvgenaucc of the blood. The degree to which the lung is permeable to oxygen is called the oxygen capacity of the lung. It is expressed in millilitres of oxygen per minute! and millimetres of mercury. This figure is obtained Opossum F i g . 2 - P. o t o f c u b e - r o o t o f b i x - t h w e i g h t ' a g a L t g e . t . t l o n - t l m e l e s s t h e ^ ^ ^ T " ^ f t C o e f fi c i e n t o f O x y g e n estimate of t„. (For further information see the original paper of "J*™51011 "** -Ung tlSSUe and lung Capillaries. Thus Huggett and widdas 1951.) ' ' a material constant, as well as the diffusion distance TIn„ addition, „ , . . „ . a• rise . . in . «hearr-rarp, . , a n h=>nH<* d * - * " - < ro - • -> s u rk'<--Tn<Mf a c e a r e ar-™A\nr. o f t h e „„„„ l u ni g., ..i s „ a,.v a„i l a° b.l e.. f ."* or output. The smaller the animal, the higher the heart-rate; surface. so the heart-rate is also roughly proportional to the In man, the diffusion capacity is 20-30 ml. oxygen per intensity of the metabolism. mni.Hg per minute, and the exchange surface is assumed dot N •Maun Manatee ,/ Bear % / •Cow pig */ Porpoise Goat.*/Man I ..o Oog Raccoon . Cat */ -Slope = 102 NSor-ef-p/j* N. N *»■*• ^w>->A--y«\ *Oog\ S Cat* Rabbit \ \ • ^V \ \ >v \ »Pctrpc/se Goat*\ N RatiA Gumeo-pig *w . \ • v a-or* Man • \ »Cow Mmto • \. % . *• ^ Dugana / % Mouse ^*Shrew \Bat 0-0001 0*01 BODY-WEIGHT (g.) b ody-wc ight. I 0-1 1 10 1 10 1 100 I 1000 I 10.000 BODY-WEIGHT (kg.) g. 4—Logarithmic plot of lung volume a« a function' weight (after Tenhey and Remmers 1963). ; -EMBER 19* 1964 THE LANCET ORIGINAL ARTICLES BREATHS per min. y ' Whole /, 1000 S l o p e '■h O s ^ / Pig Coat \ Man Dog / 100 10 r ~ .•Cow Bear/ * /* Porpoise */*. Manatee Ougotuj o n - . - . ; - R a b b i t• /, R t / .a c c o o n Armadillo •,/ car Woodchucks • Monkey 1*0 Rot /•Bumea-py 0-1 0-01 / /M • •o uSs he r e w Bat 1 1 1 ! 1 1 1000 10.000 Oj ( ml per kg per min.) STROKES per mm. Fig. 6—Logarithmic plot of alveolar surface area, a function of whole-body oxygen consumption (after Tenney and Remmers 1963). 5—Metabolic rate (ml. 0: per kg. per min.) as a function of tquencics of respiration and the heart respectively. .ncrease the amount of oxygen taken up by the blood, ess there is also an increase in the diffusion surface or decrease in the diffusion distance. During physical ivity. the diffusion capacity of the lung does indeed rease, because more blood flows through the lung itself. : an increase in perfusion and ventilation during physiactivity is unlikely to be the single way in which small mals meet their higher oxygen needs. For, even at rest, small animal—in comparison to the large animal—is a relative state of work. Probably- therefore, energy is conserved in small mals by improvement in the diffusion of oxygen in the ■gs. Since the material constants cannot be altered, this ^rovement can be achieved only by shortening the rusion distance or by a relative increase in the diffusion p02 (mm.Hg ) "face area. Macklin and Hartroft '1940) found that the Fig. 7—Oxygen dissociation curve of human blood, saturation per eolar diameter of the shrew is smaller to the second cent as c function of oxygen tension, at pK 7-2-7-6. wet than that ofthe manatee. This means an increase in eoli per unit of lung diffusion surface. glob in concentration of an animal's blood and the intensity II one roughly assumes the alveolar surface to be fully of its metabolism. The oxygen capacity of blood, an -"'jpied with capillaries, there appears to be a rather good expression of its haemoglobin concentration, ranges from "elation between the total alveolar surface and the 16 to 25 ml. oxygen per 100 ml. blood. But cats have -nsity of the particular animal's metabolism (fig. 6). the same oxygen capacity as elephants. *e smaller animals achieve their fmer rate of metabolism not only by -ive increases in ventilation and -2 •»w* elation but also by relative enlarge- £ 35 -nt of the lung surface involved in ^" :-ous exchange. S,o '^hen oxygen is taken up by the $ ^ 30 "°d in the lung capillaries, it is trans- c *: • Go/ der* hdmster^. r-ed to the tissue capillaries. The '~ -•Guntc-pig -"•sport medium, blood, is a physico- ^ -mically specialised fluid that is far g 25 -'er suited for gas transport than j; y other fluid we could think of. <_ Qxygen is loosely bound to the c*> "otnoprotein haemoglobin. One nor- »•*• 21 % finds 12-19 g. of haemoglobin 10 BODY-WEIGHT ( g.) *00 ml. blood. No correlation is p. g_Half.tatura Fig. 8—Half-saturation oxygen tension (T„) as a function of body-weight. All animals' parent, however, between the haemo- blood bloodcorrected corrected tot pH 7-4 and 37°C. 602 SEPTEMBER 19, 1964 ORIGINAL ARTICLES tensions are plotted in relation to 1 < *"". ™ ON small animals have a definitely higher half-satur, tension. " ^*t* j *-nis manner of representation was chc-w So80U*-30% ''/Shrew ,32VC ; ]2\^7i/Shrew [ J l«gues and I have added the values for v' elephant (Bartels et al. 1963a). It is evident Sf il/ : A. Krogh foretold, the larger animals wim reS! 80 100 0 2o p02 p U (mm.Hg.) 2lmmHg) 1 80 100 meless there are many exceptions. For", ^TlSSofathdl"rUtl0nTV"* (Wlth """^ P« cent and volume. *? ^ ™* « body-weight of 50 kg., has 5»*?r^sa«aasr -«—— X^^s8'^^^^ r" TT-,» ;«,«^-»— -i . ... _ . dehverv of the shrew. rnmn-ir»ri „r,ru .i , globin bond is that with a sufficient amount of oxveen in HrrhT .i-* !*&*** tCnSI°n m *■ dssues of » te the lung, haemoglobin can become saturated andwl"en 2*2? S^te Sri" "V"* desa^2 transport the oxveen ro -hP ri«i„. *«iui. ...-.._. agamst oo 0 for the shrew. In addition the mZ given_off to the cells. The oxygen dissociation lJt [tig. /) presents this relationship quite simply. With mak a mammal to oxygenate the blood in its lung capillaries arterv sufficiently at altitudes of about 12,000 ft. as well as at sea level. But, at lower oxygen tensions, between 50 and 1U mm. Hg, the oxygen-binding ability of hemoglobin decreases sharply. This means that when blood saturated with oxygen enters a tissue capiUary where the oxygen tension averages only 30 mm. Hg, almost half the chemic ally bound oxygen can be given off to the tissue. The quotient AS2/'Ap02 rises as oxygen tension falls. Hence, for particular pressure differences, more and more oxygen can be given off. 6 Not only is the numerical value of this quotient a deciding factor in the delivery of oxygen from blood to tissue, but so also is the oxygen capacity of the blood and the relationship of the quotient to the dissociation curve At what oxygen tension does the oxygenated hemoglobin begin to undergo drastic deoxygenation ? This point is by no means the same in all ammmals. One can make comparisons by determining at what oxygen tension half the hemoglobin is saturated with oxygen. This is known as the half-saturation tension. If these half-saturation though whether the shrew acrua. s pulmon-,- 11 / 3 1 WW/A Eleohant fcetus ( '2 months ) 30 Po-> (mm.Hg) / / -j Fi»-n—Oxygen dissociation curves of k / / - Another feature of the respiratory function of mac7 / M mdian biood concerns the intra-erythrocvte hemogtocr II ' eventration. M a m m33°„ a l i ahemoglobin, n e r y t h r o cand y t e sit was gene r a l l y that c o n ndo = about thought figure varied very little. In shrews, white mice, and golde • ranging from 45 to 48% (Ulrich et al. 1963), the ware content being appreciably lower. These high hemoglofc / h a m s t e r s , h o w e v e r, w e f o u n d h e m o g l o b i n c o n c e n t r a r i c e ou /u a io 20.30 40 so eo ?b Www «K>raarocm in conjunction with a high^ "Jaj* o2 pressure -,-:, - . ^1^* ™.?^Probably evolved as a result of hyV iiii im^mmmmn - - 2c£SS3S-£*- ORIGINAL ARTICLES TEMBE.t Similarly high hemoglobin concentrations were found the red cell of the camel and the llama (Bartels et al. 53a), which belong to the same family. Perhaps some; will be able to find a correlation with the extreme rdens placed upon the fluid balance of these animals. Dxygen-binding characteristics differ not only between •ious mammals but also during the life-span of the iividual. The oxygen affinity of the blood is increased "ore birth, and decreases after it. In all cases it falls tow the value for the adult. The half-saturation tension blood is 2-10 mm. Hg lower in the fcetus than in the alt (Bartels et al. 1964). Only with a 5 months' elephant rjs in Uganda did we find a virtually identical dissociaD curve in both mother and fcetus. In an elephant fcetus about 12 months the dissociation curve was shifted to : left, as in all other mammals investigated (fig. 10). The shift in the dissociation curve is much greater in wborn goats than in the elephant or human. The pur se of this mechanism seems (fig. 11) to be to increase ygen uptake from the mother's blood in the placenta. After birth, the intake of oxygen is achieved more .ciently through lung respiration. The blood no longer 90 3C Oz- Capacity o Elephant Horse . \ *k.oX« Cattle . • English. Sette* Haemoglobin < Solution Blood x* \ "Goneo-Pic °Golder. Homster Shrew t White Mouse -0-4 -0-5 -0-6 -0-7 -0-8 A log. Pq, -0-9 -1*0 & pH Fig. 13—Logarithmic plot of body-weight as a function of the Bohr effect in hemoglobin solutions and in blood. Compiled after results of Riggs (1960), Hilpen etal. (1963), Baumann et al. (1963), and Ulrich et al. (1963). s.hdoy . «ssue. as0;-27% Simultaneously with this shift there are * *'0vo1-* _ changes in oxygen capacity: the two values 1 seem to be closely related. Which is 80 28 $ 3« 70 ,6 J? 60 & THE LANCET 1 needs to have so high an oxygen affinity-, and the resulting shift to the right improves >" " the dissociation of oxygen from blood to 100 32 * mmmmmmmm* 50 primary and which secondary I shall not 20th doy t, S0,-3B% tT t0 decide; but the picture is to some liTso^MX — *«3-e'vo: 3-8vol. % % - extent clarified by the observation that the 40 oxygen tension of venous blood is one ■ of the factors regulating erythropoiesis 22 20 (Tribukait 1963). When blood has a rela7C 80 tively low oxygen affinity-, comparativelyp02 ( mm.Hg ) high tensions occur in venous blood, slowhalf-saturation oxygen tension (T,6), and,i, arteriovenous arteriovenous ing down erythropoiesis. Thus it may be 5th and 20th day (after Bartels et al. 1963b). *3b). that a mechanism not yet fully understood first changes the oxygen affinity- of the blood and then increases or decreases the (Vot.X) rate of erythropoiesis. in, oxygen ■ Human placenta u m a n p l a c e n t a In man. . * ther changes , . . . , affinity , Shrew and capacity after birth are such that a White mouse ter given difference in arterial and venous oxygen tensions during the first month of life coincides with a constant difference in the arterial-venous oxygen content (Bartels et al. 1960). This would mean that the oxygen supply is maintained constant .* despite the anzemia of the newborn result 30 ■• AGE (doys) t 12—Oxygen capacity, iiflerences in kids at the Ya k ▶ Dog -+O50 Cow t Guineo pig Goat Camel G°lden hamster Rabbit ) ■Newborn human •«—Sheep } Lan —Pig White mouse Elephant. Elephant ing from reduced oxygen affinity. 00 fo understand how the growing organ ism benefits from these changes, it is necessary not only to investigate the respiratory function of the blood but also to obtain the actual in-vivo blood-gas obblt values in arterial and venous blood. To be significant, these measurements should be made on non-an£esthetised animals. Guinea ur*opigpig Tq explain ^g meaning of these changes .. . . wea m have effort to s t e made r , every _young , lambs , obtain ,and _useful „„,„ ' information from goats Golden o l ahamster enn naJep (Bartels et al. 1963b). We placed indwelling catheters in the pulmonary artery and aorta. The animals were then observed for days **• 14—Bohr effect and "effective Bohr effect" In mammals1 (after (aftcr HUpert mipert w * 1M3, and Ulrich et al. 1963). M2 SEPTEMBER 19, 1964 ORIGINAL ARTICLES or weeks while they respired through a tracheal cannula or mask attached to a spirometer. In this manner we could follow the oxygen consumption, the blood gases, the car diac output, and the respiration from the first to about the thirtieth day after birth. From the first to the twentieth day, the half-saturation tension, as an expression of the shift to the right of the dissociation curve, increased from 20 to 31 mm. Hg. Simultaneously, the oxygen. capacity decreased almost 30% (fig. 12). On the right side of the figure two in-vivo dissociation curves are shown. At an almost unchanged mixed venous oxygen tensions, an increase in dissociation resulting in better tissue oxida tion occurred. Despite a reduced oxygen capacity, the difference between arterial-venous oxygen content remained essentially the same. Also important for oxygen transport in blood is the Bohr effect. The oxygen-binding ability of haemoglobin is influenced by the amount of carbon dioxide bound to the haemoglobin, as well as by the pH of the blood. We have enough experimental evidence to form ideas as to me possible purpose of this mechanism 'Manwell I960, Riggs 1960, Hilpert et al. 1963). Working with haemoglobin in solution, Riggs ''I960) found a good correlation between the magnitude of the Bohr effect and body-weight 'fig. 13). Accordingly, die elephant has the smallest, and the mouse the largest Bohr effect. One can see from this that the lower oxygen affinity is a further adaptation of the small animal to its intensive metabolism. When, however, one examines our findings on the extent of the Bohr effect as it actually occurs in the blood (fig. 13), the preceding correlation is found to be somewhat diminished. To understand the working of the Bohr effect in vivo, it must be interpreted in combination with the oxygen capacity and affinity of the blood. We call this the " effective Bohr effect " (Hilpert et al. 1963)— defined as the volume per cent given off by 100 ml. blood at 50% saturation, on acidification by 0-1 pH unit without a change in oxygen tension. When we look at the results of these measurements and calculations in fig. 14, our original joy disappears; for we no longer see any correlation with the intensity of metabolism. To complete this discussion, a word must be said about the nature of the blood-supply and extent of capillarisation in the organs of various animals. Just as an increase in ventilation does not necessarily mean a ereater intake of oxvcen bv rh*» bInnH_ <*n an increased blood-supply to the tissue does not necessarily mean a greater supply of oxygen to the tissue. In studies of the skeletal muscle of the horse, dog, and guineapig August Krogh (1919a and b) found that the smaller the animal the greater the number of capillaries per square millimetre of muscle tissue. Other researchers have further investigated these findings. Recently SchmidtNielsen and Pennycuik (1961) published measurements on the capillary density in animals ranging in body-weight from 9 to 450,000 g. These findings agree only roughly with those of Krogh (1919a), for there is only a slight difference in the capillary density in such widely dis similar animals as the rat and the pig (fig. 15). The concept is partially supported by the astoundingly high density of capillaries in the bat. Results are still lacking for such large animals as the elephant. Finally, it has also been found that compared with larger animals, smaller ones have higher tissue cytochrome oxidase activity (Kunkel and Campbell 1952, Kunkel THE LA* ~—| - 100 !000 CAPILLARIES (persq.mm.) Fig. 15—Logarithmic plot of body-weight as a function of capilu. per sq. mm. in gastrocnemius muscle (data from Schm Nielsen and Pennycuik 1961). et al. 1946) and cytochrome-C concentration (Drabk 1950). This further enables smaller animals with increas metabolic intensity to meet the demands of thi metabolism. Conclusion As a starting-point for our discussion we took the law diminishing metabolism, and asked die question: How it possible, with geometrically similar structures, for ; smallest animal to have a metabolic intensity a huncir times greater than that of the largest animal ? We considered the part played by oxygen transport, asaw that in smaller animals ventilation and perfusi. become relatively greater with increasing metabo intensity. As metabolism grows more intense, the dema; for more gas transport can be satisfied by increased at fusion only when the gaseous exchange surfaces oft alveoli and tissues enlarge. We have also seen th improvement in the delivery of oxygen to the tissues achieved through lowered oxygen affinity of the blood. It will be very valuable if, through new comparati experimentation, deviations from these concepts appes By more objective scrutiny we may eventually attain full understanding of that part of Nature of which we ourselv are a part. As Goethe once said: " The reason I ultimately pre: to commune with Nature, is because she is always righ:the error can only be on my side." REFERENCES Agostoni, E., Thimm, F. F., Fenn, W. O. (1959) J. appl. Physiol. 14, 6' Bartels, H., Buss, I., Kleihauer, E., Luck, C, Metcalfe, J., Riegel, i (toK., beBetke, published). —Wright, Hilpert, P. P.,(1964) Barbey, K., Riegel, K., Lang, E. M., Metcalfe (1963a) Amer. J. 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