Hypoxia normoxia and defective tissue oxygen delivery

Early heatstroke leads to inappropriate behavior and disorientation. In addition, elevated partial pressure of venous oxygen levels is evident ( Kashmeery 1995a)- This may be secondary to a reduced oxygen unloading capacity. In septic shock patients, this phenomenon has been attributed to arteriovenous shunting, which is unlikely in heatstroke patients who present with hot erythematous skin indicative of adequate blood perfusion. The delicate balance of mitochondrial energy production is susceptible to hypoxemia. Under hypoxic or normoxic conditions, a decrease in transmembrane potential, possibly due to a decrease in mitochondrial calcium, may result in inhibition of ATP synthesis. Experimentally, supplemental oxygen is unable to restore this uncoupling in mitochondria isolated from tissue previously exposed to hyperthermia or to restore the normal rate of substrate oxidation, even in the presence of calcium.

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