Postnatal changes in critical cardiac output and oxygen transport in conscious lambs.

We lowered cardiac output progressively in a controlled, stepwise fashion in conscious, unsedated lambs to determine the critical cardiac output or systemic oxygen delivery (the level at which oxygen consumption decreased abruptly). With the use of incremental inflation of a balloon-tipped catheter placed in the right atrium to lower cardiac output, we examined the response of oxygen consumption, systemic oxygen transport, fractional oxygen extraction, arterial lactate, and blood pressure. We studied lambs at 2 (n = 5), 4 (n = 5), and 8 wk (n = 6) of age and found that the 4-wk-old lambs reached critical values of cardiac output and systemic oxygen transport with the smallest proportional decreases from base-line values. Therefore, the 4-wk-old lambs were the least tolerant of acute decreases in cardiac output. We also found that fractional oxygen extraction was able to increase even after critical systemic oxygen transport was achieved. Furthermore, we found at every age that lactic acid accumulation began when the critical level of cardiac output was reached.