[Changes in the affinity of oxygen for hemoglobin during general anesthesia]

The well known effects of the lowering of the intraerythrocyte 2, 3, diphosphoglycerate (2, 3, DPG) level and hypothermia, on the affinity of oxygen for hemoglobin, lead the authors to study the influence of these parameters on this affinity during general anesthesia. The following observations were made in 15 adult subjects, undergoing prolonged general anaesthesia (average time: 3 hrs. 10 minutes): the dissociation curve of oxyhemoglobin (DCO) by the method of mixing, the intraerythrocyte 2,3, DPG level, the hemoglobin concentration and arterial blood parameters (PO2, PCO2, pH). These measurements were recorded before and after the general anaesthesia. The results were the following: a significant reduction of P50, measured under standard conditions (from 27.64 +/- 1.74 torr to 25.57 +/- 2.28, p less than or equal to 0.01) associated with a decrease in 2,3, DPG (from 0.94 +/- 0.31 mol/mol Hb at 0.64 +/- 0.24 p less than 0.01). Among the factors responsible for this variation in the affinity, it was proved that the volume of blood transfused was of importance as well as a decrease in body temperature during the operation. When the temperature is made to vary from 37 degrees C to 35 degrees C. the P50 ranges from 25.57 +/- 2.28 to 22.86 +/- 0.97 (p less than 0.01). To conclude the authors underline the importance of hypothermia and the volume of blood transfused (average time of preservation = 15 days) on the effects of the affinity of oxygen for hemoglobin.