| The Erythrocyte 2,3-diphosphoglycerate Concentration and Its Related Factors in Patients with End-stage Liver Disease. |
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Jaemin Lee, Chul Soo Park, Hae Wone Chang, Hyun Joo Kwon, Jong Ho Choi |
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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 |
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| 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. |
| Key Words:
2,3-diphosphoglycerate; end-stage liver disease; liver transplantation; oxygen-hemoglobin dissociation curve; P50 |
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