Expression of Key Enzymes in Glucose Metabolism in Chronic Mountain Sickness and Its Correlation with Phenotype / 中国实验血液学杂志

OBJECTIVE@#To explore the pathogenesis of erythrocytosis by detecting the key enzymes of glucose metabolism and glucose transporter in bone marrow erythrocytes of chronic mountain sickness (CMS), and analyzing its correlation with hemoglobin.@*METHODS@#Twenty CMS patients hospitalized in Qinghai Provincial People's Hospital from January 2019 to December 2020 were selected as CMS group. Twenty males with leukocyte count > 3.5×109/L who had accepted bone marrow aspiration and had normal result were taken as control group. The mRNA and protein expression of key enzymes and glucose transporter in glucose metabolism in bone marrow CD71+ erythrocytes were detected by real time qPCR and Western blot, respectively. Glucose, lactic acid and 2,3-diphosphoglycerate in the bone marrow supernatant and serum were tested by ELISA. The mRNA and protein expression of key enzymes and glucose transporter, glucose, lactic acid and 2,3-diphosphoglycerate of the two groups were compared. Pearson correlation was used to analyze the correlation between key enzymes, glucose transporter in glucose metabolism in bone marrow CD71+ erythrocytes and hemoglobin.@*RESULTS@#The expression of HK2, GLUT1 and GLUT2 mRNA in the CMS group were higher than those in the control group (P<0.001), while the expression of HK1, OGDH and COX5B mRNA were not different. The expression of HK2, GLUT1 and GLUT2 protein in the CMS group were higher than those in the control group (P<0.05). The levels of glucose and lactic acid in the bone marrow supernatant and serum in the CMS group were not different from those in the control group, while the level of 2,3-diphosphoglycerate was higher (P<0.001). Both HK2 and GLUT2 proteins were positively correlated with hemoglobin (r=0.511, 0.717).@*CONCLUSION@#CMS patients may increase glycolysis by increasing the expression of HK2, and promote the utilization of glucose through high expression of GLUT1 and GLUT2 to meet the need of energy supply.

Effect of Anti-Oxidative of Ethyl Pyruvate and Taurine on the Red Blood Cell Storage at 4 ℃ / 中国实验血液学杂志

OBJECTIVE@#To investigate the anti-oxidative effect of ethyl pyruvate (EP) and taurine (TAU) on the quality of red blood cells stored at 4±2 ℃, hemolysis, energy metabolism and lipid peroxidation of the red blood cells in the preservation solution were studied at different intervals.@*METHODS@#At 4±2 ℃, the deleukocyte red blood cells were stored in the citrate-phosphate-dextrosesaline-adenine-1 (CPDA-1) preservation (control group), preservation solution with EP (EP-AS), and TAU (TAU-AS) for long-term preservation. The enzyme-linked immunoassay and automatic blood cell analyzer were used to detect hemolysis and erythrocyte parameters. Adenine nucleoside triphosphate (ATP), glycerol 2,3-diphosphate (2,3-DPG) and malondialdehyde (MDA) kits were used to test the ATP, 2,3-DPG and MDA concentration.@*RESULTS@#During the preservation, the rate of red blood cell hemolysis in EP-AS and TAU-AS groups were significantly lower than that in CPDA-1 group (P<0.01). The MCV of EP-AS group was increased with the preservation time (r=0.71), while the MCV of the TAU-AS group was significantly lower than that in the other two groups (P<0.05). The concentration of ATP and MDA in EP-AS and TAU-AS groups were significantly higher than that in CPDA-1 group at the 14th day (P<0.01). The concentrations of 2,3-DPG in the EP-AS and TAU-AS groups were significantly higher than that in the CPDA-1 group from the 7th day (P<0.01).@*CONCLUSION@#EP and TAU can significantly reduce the red blood cell hemolysis rate, inhibit the lipid peroxidation level of red blood cells, and improve the energy metabolism of red blood cells during storage. The mechanism of EP and TAU may be related to their antioxidation and membrane protection effect, so as to improve the red blood cell quality and extend the preservation time.

Usefulness of P(50,std) for the Diagnostic Work-up of Patients with Erythrocytosis

High oxygen-affinity hemoglobin (Hb) variants and a 2,3-diphosphoglycerate (2,3-DPG) deficiency could cause congenital (familial) erythrocytosis. High oxygen-affinity Hb variants and a 2,3-DPG deficiency might result in low tissue oxygen tension left-shifted oxygen dissociation curves and reduction in the standard P₅₀ value (P(50,std), oxygen tension at which haemoglobin is 50% saturated). Hence, the P(50,std) value is considered while formulating diagnostic strategies for erythrocytosis. In this study, we established a reference range for P(50,std) using an International Federation of Clinical Chemistry and Laboratory Medicine-approved equation (Hill's equation) for individual single venous/arterial blood samples. Blood gas analysis results of 243 samples with oxygen saturation ranging from 40%–90% (Hb < 16 mg/dL) were selected. The reference range of P(50,std) was in the 2.5th–97.5th percentile, and was 25.9–27.3 mm Hg. Hill's equation is a simple approved method for evaluating the P(50,std) values. Only a single sample of venous or arterial blood and a blood gas analyser are required to obtain the P(50,std). Our study provides a useful tool for the diagnostic work-up of patients with erythrocytosis.

Serial assessment of biochemical parameters of red cell preparations to evaluate safety for neonatal transfusions.

Background & Objectives: Neonatologists often prefer fresh blood (<7 days) for neonatal transfusions. The main concerns for stored RBCs are ex vivo storage lesions that undermine red cell functions and may affect metabolic status of neonatal recipients. This study was designed to evaluate serial in vitro changes of biochemical parameters in different RBC preparations during storage to consider for neonatal transfusions even after storage beyond one week. Methods: Twenty five units each of whole blood (CPDA-1 RBC, SAGM RBC) were selected for serial biochemical parameter assessment after each fulfilled the quality criteria (volume and haematocrit). These units were tested serially for supernatant potassium, pH, lactate, haemoglobin, glucose and red cell 2,3 diphosphoglycerate (2,3 DPG) up to 21 days of storage. Results: Within each group of RBC, rise in mean concentration of potassium, lactate and plasma haemoglobin from day 1 to 21 of storage was significant in CPDA-1 RBC having the highest levels at day 21. From day 3 to 21, SAGM RBC had higher mean pH value than CPDA-1 RBC though this difference was not statistically significant. SAGM RBC had highest mean glucose concentration during storage than other two types of red cell preparations (P<0.005). Within each group, fall in mean 2,3 DPG concentration from day 1 to 7 was significant (P<0.05). A positive correlation existed between mean plasma potassium and haemoglobin in all three types of red cells (r=0.726, 0.419, 0.605 for CPDA-1 RBC, SAGM RBC and whole blood respectively, P<0.005). Interpretation & Conclusions: All the three red cell preparations tested revealed biochemical changes within acceptable limits of safety till 21 days of storage. CPDA-1 RBCs had the highest degree of these changes.

Spectrin interactions with globin chains in the presence of phosphate metabolites and hydrogen peroxide: implications for thalassaemia.

We have shown the differential interactions of the erythroid skeletal protein spectrin with the globin subunits of adult haemoglobin (HbA); these indicate a preference for alpha-globin over that for beta-globin and intact HbA in an adenosine 5'-triphosphate (ATP)-dependent manner. The presence of Mg/ATP led to an appreciable decrease in the binding affinity of the alpha-globin chain to spectrin and the overall yield of globin-spectrin cross-linked complexes formed in the presence of hydrogen peroxide. Similar effects were also seen in the presence of 2-,3-diphosphoglycerate (2,3 DPG), the other important phosphate metabolite of erythrocytes. The binding affinity and yield of cross-linked high molecular weight complexes (HMWCs) formed under oxidative conditions were significantly higher in alpha-globin compared with intact haemoglobin, HbA and the beta-globin chain. The results of this study indicate a possible correlation of the preferential spectrin binding of the alpha-globin chain over that of the beta-globin in the haemoglobin disorder beta-thalassaemia.

The Erythrocyte 2,3-diphosphoglycerate Concentration and Its Related Factors in Patients with End-stage Liver Disease / 대한마취과학회지

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.

Effect of human plasma on preservation of red blood cells / 中国实验血液学杂志

In order to study whether plasma can affect the structure and function of red blood cells during their storage period, the differences of pH value, concentration of K(+), Na(+), osmotic fragility, plasma hemoglobin, AchE, ATP, 2.3-DPG, P50 in suspended RBC, washed RBC, and RBC with various plasma volume at different storage times were compared. The results showed that plasma helped the blood to keep the RBC at high pH value, low K(+), high Na(+) and maintain RBC-ATP, oxygen carry capacity and deformability, but no effect on maintenance of osmotic fragility, and levels of plasma hemoglobin, AchE, ATP and 2.3-DPG was found in preservated blood. In conclusion, human plasma may be in favour of the preservation of red blood cells.

Study on effect of pH to 2,3-Diphospho glycerat level, pyruvat kinase and glucose-6-photphat dehydrogenase activity in erythrocytes preserved long-time storage

To compare the influence of the Bach Mai prepared AS-T preserving solution and Japanese Turumo firm prepared preserving solution in a same condition on the blood of 5 healthy persons of B group blood, who did not donate the blood. AS-T solution had stabilized and maintained the red blood cells, pH higher than 7 through a storage duration of 42 days. AS-T solution had maintained 2.3-DPG concentration in a level higher significantly in comparing with Terumo solution at the terminal points of the storage time PK and G6PD activities of the red blood cells mass preserved by AS-T solution as well as Terumo solution had decreased progressively in the duration of storage.

Diphosphoglycerate and phenotypic severity of sickle cell disease

Sickle cell disease is a hereditary blood disorder characterized by chronic manifestations of progressive organ failure. To control a disease of this type, it is important to study the factors which affect the course of the disease. Diphosphoglycerate [2, 3 DPG] is the most common metabolite generated by the glycolysis. It is a potent modifier for hemoglobin function. To clarify the role of 2, 3 DPG in sickling, its concentration was measured in 15 normal healthy individuals and in 12 sickle cell patients at steady state and during crisis. Hematological indices and partial oxygen tension [PO[2]] were also determined for sicklers and controls. Sickle cell patients during crisis were found to have a significantly higher levels of 2, 3 DPG [9.17 +/- 5.36 mmol/L] [p<0.05], and significantly low PO[2] [8.41 +/- 1.82 Kpa, p< 0.01] than controls [8.54 +/- 0.72 mmol/L for 2, 3 DPG and 12.44 +/- 0.7 Kpa for PO[4]]. The increase in 2, 3 DPG concentration during crisis may be due to its increased production via glycolysis, which in turn increased as a result of decreased oxygen tension during crisis. The increased 2, 3 DPG concentration increases and stabilizes the deoxygenated HbS leading to its precipitation, sickling, and hemolysis of red blood cells. In conclusion, the factors which can increase 2, 3 DPG or decrease PO[4] may lead to the sickling crisis and increase the phenotypic severity of the disease

The effects of 2,3-diphosphoglycerate, adenosine triphosphate, and glycosylated hemoglobin on the hemoglobin-oxygen affinity of diabetic patients

The position of the oxygen dissociation curve (ODC) is modulated by 2,3-diphosphoglycerate (2,3-DPG). Decreases in 2,3-DPG concentration within the red cell shift the curve to the left, whereas increases in concentration cause a shift to the right of the ODC. Some earlier studies on diabetic patients have reported that insulin treatment may reduce the red cell concentrations of 2,3-DPG, causing a shift of the ODC to the left, but the reports are contradictory. Three groups were compared in the present study: 1) nondiabetic control individuals (N = 19); 2) insulin-dependent diabetes mellitus (IDDM) patients (on insulin treatment) (N = 19); 3) non-insulin-dependent diabetes mellitus (NIDDM) patients using oral hypoglycemic agents and no insulin treatment (N = 22). The overall position of the ODC was the same for the three groups despite an increase of the glycosylated hemoglobin fraction that was expected to shift the ODC to the left in both groups of diabetic patients (HbA1c: control, 4.6 percent; IDDM, 10.5 percent; NIDDM, 9.0 percent). In IDDM patients, the effect of the glycosylated hemoglobin fraction on the position of the ODC appeared to be counterbalanced by small though statistically significant increases in 2,3-DPG concentration from 2.05 (control) to 2.45 æmol/ml blood (IDDM). Though not statistically significant, an increase of 2,3-DPG also occurred in NIDDM patients, while red cell ATP levels were the same for all groups. The positions of the ODC were the same for control subjects, IDDM and NIDDM patients. Thus, the PO2 at 50 percent hemoglobin-oxygen saturation was 26.8, 28.2 and 28.5 mmHg for control, IDDM and NIDDM, respectively. In conclusion, our data question the idea of adverse side effects of insulin treatment on oxygen transport. In other words, the shift to the left reported by others to be caused by insulin treatment was not detected

The Extended Preservation of Outdated Red Blood Cells with Rejuvesol and Additive Solutions / 대한수혈학회지

BACKGROUND: Longer RBC storage will benefit blood banker by reduced outdating and patients by receiving fewer nonviable cells and RBC breakdown products as well as by having the opportunity to participate in markedly improved autologous storage system. METHODS: We rejuvenated whole blood 10 units and RBC 15 units, on 1-3 days after expiration, then they were divided into four, washed, and suspended with four kinds of solutions containing saline adenine glucose, mannitol, and phosphate, in closed system. For the evaluation of RBCs, 30 min saline stability (SS), 2 h SS, % hemolysis, ATP, 2,3-DPG, P50, LDH, potassium, and plasma hemoglobin were tested at every week during 42 days. RESULTS: On 35th day, 30 min SS of RBCs was higher than 88% and % hemolysis of RBCs was lower than 1% in solutions containing phosphate. ATP of RBCs was the 50% of the reference value of healthy persons and 2,3-DPG of RBCs was relatively higher in solutions containing phosphate (SAGMP1, 2, 3) than in solution without phosphate (SAGM). CONCLUSION: We could successfully rejuvenate outdated RBCs and extend the expiration date to additive 35 days, but for practical use, post transfusion RBC survival and safety should be evaluated in the future.

The Preparation of Frozen Red Blood Cells and Deglycerolization of Frozen RBCs with Haemonetics V50plus / 대한수혈학회지

BACKGROUND: The method utilizing high concentration glycerol is a common way to make frozen red bool cells (RBCs) for extended period, but it requires special deglycerolization equipment for washing after thawing. For economics reason, we could not have a cell washer for wahing the frozen RBCs, so attempted to use Haemonetics V50plus that we have had. METHODS: Twelve fresh packed RBCs were cryopreserved with 40% glycerol method. After 3 months, the RBCs were thawed and washed with Haemonetics V50plus. For the evaluation of the procedure, RBC reovery rate, osmolarity, 30 min saline stability (SS), % hemolysis, ATP, 2,3-DPG, LDH, potassium, and plasma hemoglobin were tested at 24hrs after washing. RESULTS: The RBC recovery rate was 82.1 +/- 4.5% (75.8-89.2) and two units of Frozen RBCs were under 80%. The Hb ATP and Hb 2,3-DPG of RBCs were 5.2 +/- 0.6 micro mol/g Hb (3.9-6.0) and 13.0 +/- 2.1 micro mol/g Hb (8.8-15.1). The supernatant osmalrity, potassium, plasma Hb and LDH were 352 +/- 7mosmol/kg H2O (342~367), 0.8 +/- 0.2 mmol/L (0.5~1.2), 0.8 +/- 0.3 mg/dL (0.4~1.1), 352 +/- 7 U/L (342~367). The 30min SS was 98.9 +/- 0.8. CONCLUSION: We could successfully freeze, thaw, and wash the frozen RBCs with Haemonetics V50 plus.

The Preparation of Frozen Red Blood Cells and a Procedure for Deglycerolizing Frozen RBCs using COBE 2991 Blood Cell Processor / 대한수혈학회지

BACKGROUND: The cryopreservation of red blood cells (RBCs) has not ever been applied to the clinical services in Korea. The aim of this study was designed to supply the frozen-thawed RBCs as a routine service through estimation of efficiency and safety after freezing, thawing and washing. METHODS: Fifteen fresh packed RBCs were frozen with 40 percent(wt/vol) glycerol. After frozen storage at -70degrees for at least one month, the RBCs were thawed and washed in the COBE 2991 blood cell processor. We measured the blood cell count, RBC recovery rate, K+, LDH, specific gravity, osmolarity, and the percentage of hemolysis in the supernatant after deglycerolization. Autologous transfusions were done to the four voluntary donors with deglycerolized autologous blood for clinical assessment. RESULTS: The freeze-thaw-wash recovery rate of RBC was 76.8+/-10.0%, which is not enough to pass the AABB standard. But the recovery rate was increased up to 87.0+/-2.1% with the 4 stepwise predilution technique. The supernatant plasma specific gravity, osmolarity, and K+ were 1.006+/-0.001, 292+/-3 mOsm/KgH20, and 1.1+/-0.2mEq/L, respectively. The Hb ATP and 2,3-DPG were 3.6+/-0.8nmol/g and 13.4+/-4.5nmol/g. In simulated study, the free hemoglobin was 2.8+/-1.1mg/dL and 0.4+/-0.2% of total hemoglobin. In four autologous transfusion cases, plasma haptoglobin level was 96.0+/-40.8 mg/dL (reference range 30~200 mg/dL) and urine hemoglobin was not observed after 2~6 hours later after transfusion. CONCLUSION: The results of this study indicated that technical experiences for freezing, thawing and washing were established for clinical use of frozen RBCs in Korea.

Enzymes and membrane proteins of ADSOL-preserved red blood cells

CONTEXT: The preservative solution ADSOL (adenine, dextrose, sorbitol, sodium chloride and mannitol) maintains red cell viability for blood trans-fusion for 6 weeks. It would be useful to know about its preservation qualities over longer periods. OBJECTIVE: To determine some red cell biochemical parameters for peri-ods of up to 14 weeks in order to determine whether the red cell metabo-lism integrity would justify further studies aiming at increasing red cell preservation and viability. DESIGN: Biochemical evaluation designed to study red cell preservation. SETTING: Sao Paulo University erythrocyte metabolism referral center. SAMPLE: Six normal blood donors from the University Hospital of the Universidade Federal do Paranß, Curitiba, Brazil. MAIN MEASUREMENTS: Weekly assay of erythrocyte adenosine-5Ý-triphosphate (ATP), 2,3-diphosphoglycerate (2,3DPG), hexokinase (HX), phosphofructokinase (PFK), pyruvate kinase (PK), glucose-6-phosphate dehydrogenase (G-6-PD), 6-phosphogluconic dehydrogenase (6-PGD), glyceraldehyde-3-phosphate dehydrogenase (GAPD), glutathione reduc-tase (GR), glutathione peroxidase (GSHPx), plasma sodium and potas-sium, blood pH, and membrane proteins of red cells preserved in ADSOL were studied during storage for 14 weeks storage. RESULTS: During ADSOL preservation, erythrocyte ATP concentration decreased 60 percent after 5 weeks, and 90 percent after 10 weeks; the pH fell from 6.8 to 6.4 by the 14th week. 2,3-DPG concentration was stable during the first week, but fell 90 percent after 3 weeks and was exhausted after 5 weeks. By the end of the 5th week, an activity decrease of 16-30 percent for Hx, GAPD, GR, G-6-PD and 6-PGD, 35 percent for PFK and GSHPx, and 45 percent for PK were observed. Thereafter, a uniform 10 percent decay was observed for all enzymes up to the 14th week. The red blood cell membrane pro-teins did not show significant alterations in polyacrylamide gel electro-phoresis (SDS-PAGE) during the 14 weeks. CONCLUSION: Although the blood viability was shown to be poor from the 6th week up to the 14th week of storage due to ATP and 2,3-DPG depletion, the other biochemical parameters remained in fairly good condition for longer storage. As there is a gradual and uniform decay in activity throughout these 14 weeks, it seems that ADSOL-preserved red cells may be used as red cell enzyme standards and membrane proteins as well

Effects of massive transfusion on oxygen availability

Objectives: To determine oxygen derived parameters, hemodynamic and biochemical laboratory data (2,3 Diphosphoglycerate, lactate and blood gases analysis) in patients after cardiac surgery who received massive blood replacement. Design: Prospective study. Setting: Heart Institute (Instituto do Coraçao), Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil. Participants: Twelve patients after cardiac surgery who received massive transfusion replacement; six of them evolved to a fatal outcome within the three-day postoperative follow-up. Measurements and Main Results: The non-survivors group (n=6) presented high lactate levels and low P(50) levels, when compared to the survivors group (p<0.05). Both groups presented an increase in oxygen consumption and O2 extraction, and there were no significant differences between them regarding these parameters. The 2,3 DPG levels were slightly reduced in both groups. Conclusions: This study shows that patients who are massively transfused following cardiovascular surgery present cell oxygenation disturbances probably as a result of O2 transport inadequacy.

Storage-induced Changes of Plasma Free Hemoglobin, Adenosine Triphosphate, 2,3-Diphosphoglycerate of Cord Blood / 대한임상병리학회지

BACKGROUND: The use of autologous transfusion is gradually increasing since it eliminates transfusion-transmitted viral diseases, and avoids the risk of alloimmunization of red blood cells and posttransfusion graft-versus-host disease. The majority of premature neonates born at less than 1500 g need one or more red blood cell transfusion during the hospitalization and cord blood is considered as the most ideal blood for neonate autologous transfusion. In order to evaluate the adequacy of stored cord blood for autologous transfusion for neonates, the levels of plasma free hemoglobin, red blood cell adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) were measured at the time of collection, and then a week interval by 4 weeks. METHODS: The cord blood was collected in a single donor bag with CPDA-1 by aseptic technique from 28 newborns, stored for 28 days at 4degrees C, and changes in the levels of plasma free hemoglobin, red blood cell ATP and 2,3-DPG were measured at the time of collection, and then a week interval by 4 weeks for 26 cord bloods which were not presented with any bacterial growth during the storage. RESULTS: At the time of sampling, hemolysis was 0.11+/-0.16%, and intracellular ATP and 2,3-DPG were 3.74+/-0.99 mumol/g Hb and 11.67+/-1.21 mumol/g Hb, respectively. During the storage, hemolysis gradually increased to 0.61+/-1.09% on 28 days (p<0.05). ATP gradually decreased to 2.98+/-0.92 mumol/g Hb (80% of initial level) on 28 days(p<0.05). The levels of 2,3-DPG were 4.20+/-0.87 mumol/g Hb (about 35% of initial level) on 7 days(p<0.05) and 1.16+/-0.74 mumol/g Hb (less than 10% of initial level) on 28 days (p<0.001). CONCLUSIONS: In conclusion, ATP and 2,3-DPG levels of cord blood that are related to the viability of red blood cells during the storage were similar to those of adults. Thus the cord blood appeared to be an appropriate source for neonate autologous transfusion, however, more intensive studies on the effects of 2,3-DPG and metabolic products in vivo are necessary since physical conditions and physiology of the red blood cells in the neonates are different in many aspects from those of adults and children.

Erythrocyte 2,3-DPG and ATP Concentration in Intraoperative Salvaged Blood and CPD Stored Blood / 대한마취과학회지

The purpose of this study is to compare the quality of intraoperative salvaged blood with that of Citrate Phosphate Dextrose(CPD) stored blood in 32 patients having cardiac surgery involving cardiopulmonary bypass. 20 patients in the control group received one week cild CPD stored blood and 12 patients received autologous intraoperative salvaged blood which prepared and processed with the Hemonetics Cell Saver Plus autotransfusion device. 1) Salvaged blood had a higher hemoglobin concentration(l7.6 vs 13.1 g/dl, P<0.005), a higher 2.3-diphosphoglycerate concentration(3.1 vs 0.6 mmol/L, P<0.005), higher pH(7.6 vs 6.8, P<0.005) than CPD stored blood group. Salvaged blood had a lower ATP concentration was(47.7 vs 67.7 pmol/dl, P<0.005) than stored blood group. 2) Platelet count was l3.4 X 10(9)/L and WBC count was 5.09 X 10(9)/L in salvaged blood. 3) Salvaged blood volume was 1411+/-487.9 ml(range 580 to 2325 ml). Intraoperative salvaged blood had a superior oxygen carrying and delivery capacity, but modification of washing is required to lessen the platelet and white blood cell count in the salvaged blood.

A Comparative Study of 2, 3-Diphosphoglycerate Levels among Nonpregnant Women, Mothers, and their Newborn Rabies / 대한마취과학회지

Fifteen healthy pregnant women at term, between the ages of 21 and 31 years, with their newborn babies, were investigated for their 2,3-DPG levels. All the babies were born by caesarean section. Seventeen nonpregnant women in the same age range as the mother group, without cardiopulmonary disease, metabolic disorder or severe anemia, were also investigated and used as the control group. Samples were collected from umbilical vessels in newborn babies and from arm vessels in mothers and nonpregnant women. The levels of 2,3-DPG were measured by the ultraviolet enzymatic method of Sigma Chemical Company. The results were as follows: 1. The 2,3-DPG lovels in teram of whole blood among the three groups were not significantly different. 2. The 2,3-DPG levels in terms of hemoglobin, the highest in the mother group and there was no difference the between the nonpregnant women and the newborn baby groups.