The arterial blood gases, the oxygen dissociation curve, and the acid-base balance in polycythemia vera.

Abstract

Studies of the circulation and pulmonary function in normal children and in patients with polycythemia related to cyanosis in congenital heart disease raised questions concerning the extent to which polycythemia itself might be responsible for some of the abnormalities observed in the blood in cyanotic congenital heart disease. These questions concerned the possibility that the increased viscosity of polycythemic blood might prevent proper diffusion of oxygen in the alveolarcapillary system, resulting in arterial oxygen unsaturation, the characteristics of the oxyhemoglobin dissociation curve in polycythemia vera, since this has been found shifted to the right in the blood of patients with cyanotic congenital heart disease (1), and the relation of a low CO2 content and combining power to polycythemia, since these were observed to be low in the secondary polycythemia of congenital heart disease (2-4). Studies of the blood in polycythemia vera were made and compared with similar studies in cyanotic congenital heart disease. These included determinations of the oxygen content, oxygen capacity and oxygen saturation of arterial blood, the effect of breathing oxygen on the oxygen content of such blood, the oxyhemoglobin dissociation curve and the carbon dioxide content, combining