Hemodynamic oxygen transport and 2,3-diphosphoglycerate changes after transfusion of patients in acute respiratory failure Journal Article
| Authors: | Kahn, R. C.; Zaroulis, C.; Goetz, W.; Howland, W. S. |
| Article Title: | Hemodynamic oxygen transport and 2,3-diphosphoglycerate changes after transfusion of patients in acute respiratory failure |
| Abstract: | The goals of management of patients with respiratory failure include improving arterial oxygenation with PEEP and red cell transfusion to maintain oxygen carrying capacity, both of which contribute to improving tissue oxygen delivery. However, standard CPD-stored blood is rapidly depleted of 2,3 diphosphoglycerate (2,3 DPG) and ATP, with resultant inadequacy of the red cell oxygen transport function. In 15 patients requiring mechanical ventilation with PEEP whose initial Hct≤35%, we studied the effect of transfusion of 7 ml/kg of CPD-stored packed red blood cells on hemodynamic and oxygen delivery variables, pulmonary venous admixture (QA/QT), and erythrocytic P50, 2,3 DPG and ATP concentrations. Hemodynamics were not significantly altered by transfusion. 2,3 DPG decreased significantly from 14.5±1.1 to 13.1±1.5 mcmol/g Hb (mean±SD, p<0.05). There was no significant change in P50 or ATP. QA/QT rose significantly, from 20.1±7.8 to 28.9±12.3% (mean±SD, p<0.02). In our patients, an increase in arterial oxygen content obtained by transfusion was not followed by any associated decrease in cardiac work, as implied by solution of equations for oxygen delivery and oxygen consumption. The rise in QA/QT is undesirable in patients requiring PEEP, since it complicates management of their mechanical ventilatory support. © 1986 Springer-Verlag. |
| Keywords: | clinical article; comparative study; oxygen; cardiovascular system; blood transfusion; adenosine triphosphate; erythrocyte transfusion; oxygen consumption; oxygen transport; therapy; hemoglobins; hemodynamics; respiratory insufficiency; respiratory failure; hematocrit; organophosphorus compounds; transfusion; respiratory system; positive end expiratory pressure; human; priority journal; positive-pressure respiration; lung shunting; 2,3 diphosphoglyceric acid; pulmonary wedge pressure; vascular resistance; blood and hemopoietic system; 2,3 diphosphoglycerate; 2,3-diphosphoglycerate; diphosphoglyceric acids |
| Journal Title: | Intensive Care Medicine |
| Volume: | 12 |
| Issue: | 1 |
| ISSN: | 0342-4642 |
| Publisher: | Springer Verlag |
| Date Published: | 1986-01-01 |
| Start Page: | 22 |
| End Page: | 25 |
| Language: | English |
| DOI: | 10.1007/bf00315364 |
| PUBMED: | 3519720 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 18 August 2021 -- Source: Scopus; Acknowledgments: The authors wish to thank Ms. Christine Brandon for preparation of this manuscript. |
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