Role of hemoglobin and capillarization for oxygen delivery and extraction in muscular exercise.

Through the years the role of the various links in the transport of oxygen in the human body has been discussed extensively, and especially whether one of these links could be singled out as limiting oxygen uptake during exercise. In his thesis work Lars Hermansen dealt with several of these variables related to oxygen transport and uptake. Two of these were the hemoglobin concentration of the blood (Hb) and skeletal muscle capillarization. These are the focus of this article. It can be demonstrated that variation in arterial oxygen content due to different Hb concentrations is fully compensated for at the level of the muscle, i.e. the amount of oxygen delivered to contracting muscles is adjusted by a variation in the blood flow so that it is the same regardless of Hb concentration in the range of 118-172 g X l-1. At the systemic level, with a large fraction of the muscle exercising, this causes an increase in submaximal heart rate and a lowering in maximal oxygen uptake in people with low as compared to normal or high Hb concentration. The primary significance of an enlarged capillary network in the muscle does not appear to be for accommodating a larger flow, but rather to allow for a long enough mean transit time and large enough surface area for optimal exchange of gases, substrates and metabolites.