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Daniel B. Allen, MD; John J. Maguire, DDS; Mani Mahdavian, MD; Corinna Wicke, MD; Lucia Marcocci, PhD; Heinz Scheuenstuhl; Michael Chang; Anh X. Le, MD; Harriet W. Hopf, MD; Thomas K. Hunt, MD

Arch Surg. 1997;132(9):991-996.

Abstract
Background
"Respiratory burst" activity, ie, O₂–production, is dependent on Po₂, temperature, pH, and glucose concentrations within the physiologic range.

Objectives
To determine whether environmental conditions characteristic of wounds may limit human neutrophil respiratory burst metabolism and to clarify the degree to which bactericidal oxidant production depends on local Po₂.

Methods
Human blood and wound neutrophils were stimulated with phorbol myristate acetate. Oxygen consumption and superoxide production were measured over a range of 30 to 300 mm Hg Po₂, 0 to 40 mmol/L glucose, pH 6.0 to 8.0, and 30°C to 37°C. The apparent Michaelis Menten constant for oxidant production with respect to Po₂ was calculated.

Results
Oxygen consumption and O₂–production were dependent on Po₂ throughout the range tested. Half-maximal oxidant production occurred in the range of 45 to 80 mm Hg Po₂ and maximal at Po₂ higher than 300 mm Hg. These data agree with the highest previous estimates. Oxidant generation was also dependent on pH, temperature, and glucose concentration, but to a lesser extent.

Conclusions
Leukocyte bacterial killing capacity as measured by oxygen consumption and superoxide production are substantially impaired at the low oxygen tensions often found in wounds. Changes in pH, temperature, and glucose concentration have lesser but nonetheless significant consequences. The data provide a plausible mechanism for the vulnerability of some wounds to infection and for the previous finding that increasing oxygen tension at wound sites enhances bactericidal function. Thus, the data serve as a basis for future studies on prevention of wound infection.

Arch Surg. 1997; 132:991-996

Author Affiliations
From the Departments of Anesthesia (Dr Hopf) and Surgery (Drs Mahdavian, Wicke, Le, Hopf, and Hunt and Messrs Scheuenstuhl and Chang), University of California, San Francisco; the Department of Surgery, University of California, Davis (Dr Allen); and the Energy and Environment Division, Lawrence Berkeley National Laboratory (Dr Maguire) and the Department of Molecular and Cell Biology (Dr Marcocci), University of California, Berkeley.

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