Abstract
Attempts were made to enhance oxygen availability in patients undergoing coronary artery bypass operations by transfusing red blood cells enriched in 2,3 diphosphoglycerate (2,3 DPG) to 150% of normal. In this study of 22 patients, 11 received red blood cells with high 2,3 DPG levels and 11 received red blood cells with 70% of normal 2,3 DPG levels (control). Immediately following cardiopulmonary bypass the 11 patients who received high 2,3 DPG red blood cells had a P 50 value of 31.6 mm Hg; the value in control patients was 28.3 mm Hg ( p < 0.05). Oxygen consumption values were 135 and 106 ml/min/m 2, respectively ( p < 0.05). Mixed venous oxygen tensions were similar in the two groups, but the arteriovenous content difference was higher in the high 2,3 DPG group ( p < 0.05). Cardiac indices increased significantly in response to a fluid load in the high 2,3 DPG group compared with controls at comparable filling pressures. We believe the improved myocardial performance in response to a fluid challenge is a result of increased oxygen availability.
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