Polycythaemia in Coal Miners with Chronic Lung Disease

Chan, B. W. B.

doi:10.1136/bmj.2.5653.349

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…This subnormal response has been attributed in turn to severe hypoxia, hypercapnia, iron deficiency, chronic infection, and gastrointestinal bleeding. In contrast, others have demonstrated a normal red cell volume response to hypoxia in these patients (Hurtado, Merino and Delgado, 1945;Hammarsten, Whitcomb, Johnson, and Lowell, 1958;Shaw and Simpson, 1961;Lertzman, Israels, and Cherniack, 1962;Hume, 1968;Chan, 1969). Plasma volume is usually unrelated to hypoxia and tends to fall within the normal range, except for the studies of Shaw andSimpson (1961) andVanier et al (1963), in which it was increased.…”

Section: Royal Infirmary Sheffield and Northern General Hospital Shmentioning

confidence: 94%

Blood volume studies in chronic obstructive non-specific lung disease

Cocking¹,

Darke²

1972

Thorax

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Blood volume studies.-in chronic hypoxic lung disease have produced conflicting results. Some have demonstrated that the red cell volume-hypoxic relationship is similar to that in normal subjects, whereas others have found that it is subnormal. Plasma volume has not been shown to be related to hypoxia. To elucidate this further, 45 patients with chronic obstructive bronchitis were studied. They were on average hypoxic at rest and on exertion, but mean values of red cell volume, plasma volume, venous haematocrit, red cell count, and haemoglobin concentration were normal. Red cell volume was linearly related to the degree of hypoxia, but the response was subnormal. Arterial oxygen saturation rather than tension was the main determinant of red cell volume, and resting values correlated better than exercise values with red cell volume. The best correlations were obtained when red cell volume was expressed as a function of the lean body mass rather than the total body weight. Red cell volume was also linearly related to arterial Co tension. Plasma volume did not correlate with any of the blood gases. The subnormal polycythaemic response to hypoxia may have been caused partially by latent iron deficiency and chronic infection; but severe hypoxia, hypercapnia, and gastrointestinal bleeding were not aetiological factors. The importance of tissue hypoxia in the regulation of the erythropoietic response and the reasons why previous blood volume studies have produced conflicting results are discussed.There is general agreement that -red cell volume, but not plasma volume, is linearly correlated with the level of hypoxia in healthy -subjects living at altitude (Shaw and Simpson, 1961;Weil, Jamieson, Brown, and Grover, 1968). Plasma volume is usually normal or slightly reduced at altitude (Hurtado, Merino, -and Delgado, 1945;Reynafarje, Lozano, and Valdivieso, 1959;Pugh, 1962;Weil et al., 1968).Blood volume studies in chronic obstructive non-specific lung disease have produced conflicting results. Some workers have concluded that red cell volume is not consistently elevated in a quantitatively normal manner for the level of hypoxia (Lemon,

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Section: Royal Infirmary Sheffield and Northern General Hospital Shmentioning

confidence: 94%

Blood volume studies in chronic obstructive non-specific lung disease

Cocking¹,

Darke²

1972

Thorax

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“…However, the total red cell volume and the haemoglobin mass were often found to be less than expected (12, 19,33); a suboptimal haematologic response was shown despite normal erythrocyte life (7,12,29,33) and apparently adequate production of erythropoietin (6,7,23,33). Only in a group of ex-miners with chronic bronchitis and/or silicosis did a close correlation between arterial oxygen saturation and the haematologic data point to an adequate polycythaemic response (4). Conflicting results were also found in recent studies including measurement of arterial oxygen tension; this can be due to small groups of patients (34) and/or a selection that involved a predominance of patients with haemoglobin concentrations and/or haematocrits within ( 5 ) or above (13,15,16) the normal range.…”

mentioning

confidence: 97%

Haematologic Adaptation in Patients with Chronic Bronchitis and Pulmonary Insufficiency

Skouby¹

1976

Journal of Internal Medicine

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The relationship between respiratory insuftlciency, expressed by gas tensions in blood and bone marrow, and haematologic adaptation has been studied in 82 men with chronic bronchitis and persistent breathlessness for at least one year. For the group as a whole and for various subgroups, a linear correlation was demonstrated between arterial hypoxia and Hb concentration, haematocrit, blood volume, Hb mass and erythrocyte volume, respectively. The increase in Hb concentration compensated for the fall in arterial oxygen saturation. Only for one subgroup, with a pH difference between arterial and venous blood 30.08, was no correlation found between the degree of hypoxia and Hb concentration. The haematologic parameters correlated significantly better with arterial oxygen tensions than with oxygen tensions in the bone marrow. There was no indication that decreased oxygen supply to the bone marrow led to the increased erythrocyte and Hb production in patients with arterial hypoxia caused by chronic bronchitis. Acta med. scand. 199

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