Oxygen Dissociation Curve in the Adult Respiratory Distress Syndrome

Huang, W.-N.; Cade, J. F.; Pain, M. C. F.

doi:10.1177/0310057x9202000410

Cited by 6 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In similar fashion, no association between serum phosphate concentrations and the standard P50 (and by implication 2,3-DPG concentrations) was identified in the studies of Myburgh 4 or Huang 5 , nor was Myburgh able to detect an influence of haemoglobin concentration on standard P50 4 . It therefore seems unlikely that serum phosphate or blood haemoglobin concentrations are important causes of altered 2,3-DPG concentrations or P50 in the majority of critically ill patients.…”

Section: Discussionmentioning

confidence: 74%

“…Although the authors speculated on the possibility of reduced 2,3-DPG concentrations, no measurements were made. In a similar investigation by Huang and coworkers 5 , patients with ARDS were shown to have a reduced mean standard P50 when compared with normal controls. The authors were unable to suggest a cause for this reduction.…”

mentioning

confidence: 73%

“…There have been a number of investigations into whether haemoglobin-oxygen affinity is increased, normal or decreased in critical illness, but the data thus far have been inconclusive and conflicting [1][2][3][4][5] . The answer to this question may be important, since factors affecting binding of oxygen to haemoglobin influence tissue oxygenation in low perfusion states [6][7][8][9][10][11] and possibly also in severe hypoxaemic respiratory failure with right-to-left shunting 12 .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased in Vivo P50

Morgan¹,

Koch²,

Morris

et al. 2001

Anaesth Intensive Care

View full text Add to dashboard Cite

We investigated whether red cell 2,3-diphosphoglycerate (2,3-DPG) concentrations are reduced in critical illness, whether acidaemia, hypophosphataemia or anaemia influence 2,3-DPG, and whether there is any net effect on in vivo P50. Twenty healthy, non-smoking, male volunteers were compared with 20 male intensive care patients with APACHE 2 scores >20 on the preceding day. Those transfused in this time were excluded. Venous red cell 2,3-DPG concentrations were measured in both groups. In the patient group, routine multichannel biochemical profile and arterial blood gas analysis were also performed and in vivo P50 calculated. The mean 2,3-DPG concentration was significantly lower in the patient group than in the controls (4.2±1.3 mmol/l vs 4.9±0.5 mmol/l, P=0.016). The patients were well oxygenated (lowest arterial PO 2 =75 mm Hg) and showed a tendency to acidaemia (median pH 7.37, range 7.06 to 7.48) and anaemia (median haemoglobin concentration 113 g/l, range 89 to 154 g/l). By linear regression of patient data, pH had a significant effect on 2,3-DPG concentrations (r=0.6, P=0.011). Haemoglobin and phosphate concentrations did not, but there were few abnormal phosphate values. There was no correlation between 2,3-DPG concentrations and in vivo P50 (r 2 ≤ 0.08). We conclude that 2,3-DPG concentrations were reduced in a broad group of critically ill patients. Although this would normally reduce the P50, the reduction was primarily linked with acidaemia, which increases the P50. Overall, there was no net effect on the P50 and thus no affinity-related decrease in tissue oxygenation.

show abstract

Section: Discussionmentioning

confidence: 74%

mentioning

confidence: 73%

mentioning

confidence: 99%

See 1 more Smart Citation

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased in Vivo P50

Morgan¹,

Koch²,

Morris

et al. 2001

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…Myburgh et al reported reduced P50 in critically ill patients 37 , whereas two recent investigations 38,39 revealed no difference in P50 compared to the healthy population. Focusing on ARDS, an Australian group demonstrated leftward shifts of the oxyhemoglobin dissociation curves 40 . In contrast, a group of Belgium ARDS patients demonstrated a rightward shifted curve 41 , which is consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

P50 implies adverse clinical outcomes in pediatric acute respiratory distress syndrome by reflecting extrapulmonary organ dysfunction

Kim

Jung

Kim

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Hypoxemia and multiple organ dysfunction are significant contributors to mortality in patients with pediatric acute respiratory distress syndrome (PARDS). P50, the oxygen tension at which hemoglobin is 50% saturated, is a measure of hemoglobin-oxygen affinity, and its alteration might have implications for tissue hypoxia and organ dysfunction. The purpose of this single-center, retrospective study was to evaluate P50 levels in PARDS and to determine the association between P50 and clinical outcomes. The study included 212 children diagnosed with PARDS according to the Pediatric Acute Lung Injury Consensus Conference definition who required invasive mechanical ventilation and had arterial blood gas results of hemoglobin oxygen saturation < 97% at the time of diagnosis. P50 levels were calculated using Doyle’s method, and organ dysfunction was assessed using the Pediatric Logistic Organ Dysfunction-2 score. Most patients exhibited more than one dysfunctional extrapulmonary organ at PARDS onset. P50 increased with increasing PARDS severity (mild (26.6 [24.9–29.6]), moderate (26.8 [25.0–29.5]), and severe PARDS (29.1 [26.1–32.4] mmHg; P = 0.025). Moreover, P50 demonstrated a significant positive association with extrapulmonary organ dysfunction score (β = 0.158, P = 0.007) and risk of mortality (adjusted hazard ratio, 1.056; 95% confidence interval, 1.015–1.098; P = 0.007), irrespective of initial PARDS severity. The relationship between P50 and mortality was largely mediated by extrapulmonary organ dysfunction. A high P50 value at the time of PARDS diagnosis may be associated with mortality via dysfunctional extrapulmonary organs. Future studies should consider P50 as a potential candidate index for risk stratification of PARDS patients.

show abstract

The Significance of the P50

Morgan¹

1999

Yearbook of Intensive Care and Emergency Medicine

View full text Add to dashboard Cite

Oxygen Dissociation Curve in the Adult Respiratory Distress Syndrome

Cited by 6 publications

References 11 publications

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased in Vivo P50

Reduced Red Cell 2,3-Diphosphoglycerate Concentrations in Critical Illness without Decreased in Vivo P50

P50 implies adverse clinical outcomes in pediatric acute respiratory distress syndrome by reflecting extrapulmonary organ dysfunction

The Significance of the P50

Contact Info

Product

Resources

About