Lactic Acidemia in Baboons after Transfusion of Red Blood Cells with Improved Oxygen Transport Function and Exposure to Severe Arterial Hypoxemia

Abstract

Baboons were bled one-third of their blood volume and then transfused with an equivalent volume of compatible donor red blood cells with 160 per cent of normal 2,3-diphosphoglycerate (2,3-DPG) levels and improved capacity to release oxygen to tissue. The mixture of baboon donor-recipient red blood cells in the circulation had a 2,3-DPG level of 130 per cent of normal. After transfusion, the baboon's inspired oxygen was first lowered from 21 to 10 per cent to produce severe arterial hypoxemia with a PO2 tension of less than 40 mm Hg for two hours and then restored to 21 per cent. Lactic acidemia occurred when the alveolar oxygen tension was reduced so as to produce an arterial oxygen tension of less than 40 mm Hg, even though oxygen consumption was maintained. The data suggest that when red blood cells with normal or improved oxygen delivering capacity are transfused to patients, the alveolar oxygen tension should be sufficient to maintain an arterial oxygen tension of greater than 40 mm Hg.

Rejuvenation of allogenic red cells: benefits and risks

“…In this model, transfusion of rejuvenated red cells was shown to increase the 2,3‐DPG, ATP and p50 of circulating blood. This was demonstrated to have a range of benefits in simulated clinical settings including anaemia , haemorrhagic shock and hypoxia . Benefits most commonly seen included improved myocardial workload and cerebral blood flow in anaemic animals .…”

The survival and function of baboon red blood cells, platelets, and plasma proteins: a review of the experience from 1972 to 2002 at the Naval Blood Research Laboratory, Boston, Massachusetts

“…10). The data suggest that when RBCs with normal or improved oxygen‐delivering capacity are transfused to patients, the alveolar oxygen tension should be sufficient to maintain an arterial oxygen tension of greater than 40 mmHg 22 …”

Repeated Intravenous Administrations of Human Albumin and Human Fibrinogen in the Baboon: Survival Measurements

“…The baboon is a highly satisfactory animal for such studies because its coagulation and oxygen transport system are similar to those of human subjects [1][2][3][4][5][6][7]. Many studies require an accu- The opinions or assertions contained herein are those of the authors and are not to be construed as official or reflecting the views of the Navy Department or Naval Service at large.…”

“…Certain studies of cardiovascular and hematologic dynamics are better carried out in animals than in man. The baboon is a highly satisfactory animal for such studies because its coagulation and oxygen transport system are similar to those of human subjects [1‐7]. Many studies require an accurate estimation of the animal's blood volume which is determined from the dilution of radiolabeled proteins injected into the circulation.…”