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Ann Thorac Surg 1978;26:17-26
© 1978 The Society of Thoracic Surgeons

Articles

Transfusion of 2,3 DPG-Enriched Red Blood Cells to Improve Cardiac Function

Richard C. Dennis, M.D., Herbert B. Hechtman, M.D., Robert L. Berger, M.D.*, Louis Vito, M.D., Richard D. Weisel, M.D., C. Robert Valeri, CAPT, MC, USNR

Department of Surgery, Boston University Medical Center, and The Naval Blood Research Laboratory, Boston, MA

Accepted for publication December 2, 1977.

* Address reprint requests to Dr. Berger, University Hospital, 75 E Newton St, Boston, MA 02118

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 P50 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/m2, 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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