The Erythrocyte 2,3-diphosphoglycerate Concentration and Its Related Factors in Patients with End-stage Liver Disease.
10.4097/kjae.2007.52.4.430
- Author:
Jaemin LEE
1
;
Chul Soo PARK
;
Hae Wone CHANG
;
Hyun Joo KWON
;
Jong Ho CHOI
Author Information
1. Department of Anesthesiology and Pain Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. cjh1545@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
2,3-diphosphoglycerate;
end-stage liver disease;
liver transplantation;
oxygen-hemoglobin dissociation curve;
P50
- MeSH:
2,3-Diphosphoglycerate*;
Cardiac Output;
Erythrocytes*;
Hemodynamics;
Humans;
Hydrogen-Ion Concentration;
Lactic Acid;
Liver Diseases*;
Liver Transplantation;
Liver*;
Oxygen;
Tissue Donors
- From:Korean Journal of Anesthesiology
2007;52(4):430-437
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It is believed that an increase in the level of erythrocyte 2,3-diphosphoglycerate is an important compensatory mechanism that allows satisfactory tissue oxygenation in hypoxic patients. This study measured the level of 2,3-diphophoglycerate and the factors affecting its concentration, as well as the position of the oxygen-hemoglobin dissociation curve in patients with end-stage liver disease. METHODS: Fifty patients receiving liver transplantation (experimental group) and forty-five healthy donors (control group) were enrolled in this study. Arterial-mixed venous oxygen content difference, whole body oxygen delivery and consumption were measured after determining the hemodynamic parameters including cardiac output in the experimental group. The erythrocyte 2,3-diphosphoglycerate level was measured using assay procedures. The P50 value was used to determine the position of the oxygen-hemoglobin dissociation curve. RESULTS: The 2,3-diphosphoglycerate level was higher in patients with end-stage liver disease than in the controls. A 0.3 g/L increase in the 2,3-diphosphoglycerate concentration corresponded to a P50 increase in 1.2 mmHg with a rightward displacement of the oxygen-hemoglobin dissociation curve. The 2,3-diphosphoglycerate concentration showed a significant correlation with the PaO2, Ca-vO2, P50, and blood lactate level, but not with the hemodynamic parameters such as the cardiac index, oxygen delivery index, and pH. CONCLUSIONS: End-stage liver disease is associated with an increase in the level of the erythrocyte 2,3-diphosphoglycerate and P50. This is believed to be an important compensatory mechanism to allow better tissue oxygenation. An increase in the 2,3-diphosphoglycerate level correlates well with the oxygenation parameters, rather than with the hemodynamic parameters.
