Red-Cell 2,3-Diphosphoglycerate and Creatine Levels in Patients with Red-Cell Mass Deficits or with Cardiopulmonary Insufficiency

Cr, Valeri; Nl, Fortier

doi:10.1056/nejm196912252812605

Cited by 99 publications

(33 citation statements)

References 25 publications

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“…They are the best fit lines connecting the means of subjects in classes I through III. If V02 for class II, III, and IV subjects was recalculated at the P50 in vivo of class I The dependence of P50 std upon hemoglobin concentration in the present study was less than that observed in anemic subjects in our own (25) and other laboratories (26,27). This is likely due to the fact the blood pH and Hb/HbO2 ratio were dependent on other variables, as well as hemoglobin concentrations in these subjects.…”

Section: Methodscontrasting

confidence: 61%

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The Relationships between Arterial Oxygen Flow Rate, Oxygen Binding by Hemoglobin, and Oxygen Utilization after Myocardial Infarction

Lichtman¹,

Cohen²,

Young³

et al. 1974

J. Clin. Invest.

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A B S T R A C T The interrelationships of arterial oxygen flow rate index, oxygen binding by hemoglobin, and oxygen consumption have been examined in patients with acute myocardial infarction. Proportional extraction of oxygen increased in close association with decreasing oxygen flow rate, and hence, whole body oxygen consumption was constant over nearly a threefold variation in arterial oxygen flow rate. A reduction in hemoglobin-oxygen affinity at in vivo conditions of pH, PCo2 and temperature also occurred in proportion to the reduction in arterial oxygen flow rate. Therefore, the increased proportional removal of oxygen from arterial blood at low oxygen flow rates, required to maintain oxygen consumption, may have been facilitated by the reduced affinity of hemoglobin for oxygen at in vivo conditions. However, the decrease in affinity did not appear to explain more than 30-40%0 of the increased extraction.Respiratory alkalosis was a frequent occurrence in these patients and 2,3-diphosphoglycerate was positively associated with blood pH as well as with the time-averaged proportion of deoxyhemoglobin in arterial and venous blood.Hemoglobin-oxygen affinity measured at standard conditions and the mixed venous oxygen saturation were equally good indicators of reduced arterial oxygen flow rate in patients without shock. However, Svro2 is more easily measured and is a more useful indicator of reduced oxygen flow rate, since its relationship to oxygen flow appears to be independent of affinity changes and time.

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Section: Methodscontrasting

confidence: 61%

“…Neither is a highly accurate predictive index of oxygen flow in an individual subject, since the 95% tolerance limits for OFIa for a given v or P30 std are too broad to be used precisely. Nevertheless, serial measurements of Svo2 may be of value, as has been previously suggested (26,27).…”

Section: Methodsmentioning

confidence: 63%

The Relationships between Arterial Oxygen Flow Rate, Oxygen Binding by Hemoglobin, and Oxygen Utilization after Myocardial Infarction

Lichtman¹,

Cohen²,

Young³

et al. 1974

J. Clin. Invest.

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“…As an isolated finding this might indicate that the increase in 2,3-DPG synthesis and the rise in Po250% are parts of the ordinary anti-hypoxia mechanisms observed during other types of ordinary anemia (2,7,19,20). But the complete lack of corresponding relationship between 2,3-DPG, Po250%, Hb, and available O2 in the iron-treated animals demonstrated that no such causal relationship exists.…”

Section: Discussionmentioning

confidence: 88%

“…Previous studies indicate that the postnatal fall in blood hemoglobin concentration of young rabbits, 1-10-d-old, is nearly perfectly matched by a shift to the right of the hemoglobin 0 2 dissociation curve, which results in complete maintenance of the O2 delivery capacity of the blood (8). The close correlation between the rise in Po2%% and erythrocyte 2,3-DPG and the fall in Hb, together with the fact that the O2 affinity of pure hemoglobin remains the same throughout the postnatal period (9,12) suggest that the O2 delivery capacity of the blood is preserved by the same mechanisms that counter hypoxia in other types of anemia (2,7,19,20). The possibility also exists that an initial rise in 2,3-DPG and Po250% together with the increase in arterial Po2 following the change from intrauterine to extrauterine life so improve the delivery of O2 to the tissucs that the hematopoietic stimuli are reduced and lead to a decline in Hb.…”

Section: Discussionmentioning

confidence: 97%

Erythrocyte 2,3-Diphosphogly cerate, Po250%, and Available Oxygen in Young Rabbits with and without Postnatal Fall in Hemoglobin

Holter¹,

Halvorsen²,

Refsum³

1984

Pediatr Res

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“…A negative correlation has been observed between Hb levels and the levels of DPG in normal people (3,4). Measurement of red-cell DPG levels has been used as a "functional biopsy" of the adequacy of tissue oxygenation (5). Whereas the correlation between DPG and Hb level may not be causal, feedback mechanisms appear to regulate them in tandem.…”

mentioning

confidence: 99%

Univariate Genetic Analysis of Oxygen Transport Regulation in Children: The Medical College of Virginia Twin Study

et al. 1993

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ABSTRACT. We investigated the relative contributions of genetic, individual environmental, and shared environmental effects on 2,3-diphosphoglycerate (DPG) regulation in preadolescent children. In a population of 165 early pubescent boy and girl twin pairs (11.4 y old), of whom 63 were passive smokers, we asked: 1 ) Are there differences in the control of DPG levels between early pubertal boys and girls? 2) If present, are these differences influenced by exposure to passive cigarette smoke? Non-passive-smoking boys and girls had similar DPG levels. With exposure to passive smoke, DPG levels increased in boys ( p = 0.02) but not in girls. Analysis of variance on DPG demonstrated a parental smoking effect ( p = 0.008) and suggested an interactive effect between parental smoking and sex of the child (p = 0.08). Univariate genetic analyses suggested that genes operated at different magnitudes in boys (9%) and girls (39%) in explaining a significant portion of the variance in DPG. The magnitude of shared environmental influences was greater in boys (62%) than in girls (34%), whereas individual environmental effects were similar in boys (29%) and girls (26%). Early pubertal boys differ from girls in their regulation of DPG. Environmental stressors such as passive cigarette smoke may elicit different responses in males and females, even at an early age. The use of path analysis may provide important insights into the mechanisms and interactions of genetic and environmental effects that underly the childhood antecedents of atherosclerotic heart disease. (Pediatr Res 33: [645][646][647][648] 1993) Abbreviations DPG, 2,3-diphosphoglycerate Systemic oxygen transport is accomplished using many integrated, self-regulated organ systems. Essential components of this system include pulmonary gas exchange, blood flow, Hb concentration, and Hb affinity for oxygen (1). Organic phosphates within the red cell decrease the oxygen affinity of Hb. The most important quantitatively is DPG. The mechanism of the DPG effect on oxygen affinity involves binding of DPG to the two beta chains in the central cavity of deoxy Hb, forcing a conformational shift that drives oxygen off. Oxyhemoglobin (as well as carboxyhemoglobin) binds DPG poorly because of a stereochemically smaller central cavity created by changes in the quarternary structure of Hb with oxygenation (2). An increase in red-cell DPG compensates for an impairment in oxygen supply to tissue and is proportional to the increase in deoxyhemoglobin concentration.Considerable variation in DPG levels, Hb levels, and oxygen affinity occurs in the normal population. A negative correlation has been observed between Hb levels and the levels of DPG in normal people (3, 4). Measurement of red-cell DPG levels has been used as a "functional biopsy" of the adequacy of tissue oxygenation (5). Whereas the correlation between DPG and Hb level may not be causal, feedback mechanisms appear to regulate them in tandem. Therefore, DPG may function as a monitor for environmental influences on systemic ...

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Red-Cell 2,3-Diphosphoglycerate and Creatine Levels in Patients with Red-Cell Mass Deficits or with Cardiopulmonary Insufficiency

Cited by 99 publications

References 25 publications

The Relationships between Arterial Oxygen Flow Rate, Oxygen Binding by Hemoglobin, and Oxygen Utilization after Myocardial Infarction

The Relationships between Arterial Oxygen Flow Rate, Oxygen Binding by Hemoglobin, and Oxygen Utilization after Myocardial Infarction

Erythrocyte 2,3-Diphosphogly cerate, Po250%, and Available Oxygen in Young Rabbits with and without Postnatal Fall in Hemoglobin

Univariate Genetic Analysis of Oxygen Transport Regulation in Children: The Medical College of Virginia Twin Study

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