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O2 in severe anemia
A. C. Burton Vascular Biology Laboratory, University of Western Ontario, London, Ontario, Canada N6A 4G5
Reducing the
hemolobin (Hb)-O2 binding affinity facilitates
O2 unloading from Hb, potentially increasing tissue
mitochondrial O2 availability. We hypothesized that a
reduction of Hb-O2 affinity would increase O2
extraction when tissues are O2 supply dependent, reducing
the threshold of critical O2 delivery
(DO2 CRIT). We investigated the effects of
increased O2 tension at which Hb is 50% saturated
(P50) on systemic O2 uptake
(
O2 SYS),
DO2 CRIT, lactate production, and acid-base
balance during isovolemic hemodilution in conscious rats. After
infusion of RSR13, an allosteric modifier of Hb, P50
increased from 36.6 ± 0.3 to 48.3 ± 0.6 but remained unchanged at 35.4 ± 0.8 mmHg after saline (control, CON).
Arterial O2 saturations were equivalent between RSR13 and
saline groups, but venous PO2 was higher and
venous O2 saturation was lower after RSR13. Convective
O2 delivery progressively declined during hemodilution reaching the DO2 CRIT at 3.4 ± 0.8 ml · min
1 · 100 g
1 (CON)
and 3.6 ± 0.6 ml · min
1 · 100 g
1 (RSR13). At Hb of 8.1 g/l
O2 SYS started to decrease
(CON: 1.9 ± 0.1; RSR13: 1.8 ± 0.2 ml · min
1 · 100 g
1) and
fell to 0.8 ± 0.2 (CON) and 0.7 ± 0.2 ml · min
1 · 100 g
1 (RSR13).
Arterial lactate was lower in RSR13-treated than in control animals
when animals were O2 supply dependent. The decrease in base
excess, arterial pH, and bicarbonate during O2 supply dependence was significantly less after RSR13 than after saline. These
findings demonstrate that during O2 supply dependence
caused by severe anemia, reducing Hb-O2 binding affinity
does not affect
O2 SYS or
DO2 CRIT but appears to have beneficial
effects on oxidative metabolism and acid base balance.
oxygen affinity; oxygen transport; RSR13; oxygen supply dependency; critical oxygen delivery; anemia
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