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Related Concept Videos

Oxygen Transport in the Blood01:27

Oxygen Transport in the Blood

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Hemoglobin (Hb) is a crucial molecule in the human body, consisting of four polypeptide chains, each bound to an iron-containing heme group. This unique structure enables hemoglobin to bind to oxygen, with each molecule capable of combining with four molecules of oxygen, leading to rapid and reversible oxygen loading. When fully loaded with oxygen, it is called oxyhemoglobin, while hemoglobin that has released oxygen is called reduced hemoglobin or deoxyhemoglobin. As hemoglobin binds oxygen,...
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Hemoglobin01:24

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Hemoglobin is a globular protein made up of four subunits. Two of these subunits are alpha chains, and the other two are beta chains. Each subunit contains a molecule of heme, which has an iron atom and can bind to oxygen. When an oxygen molecule binds to one heme group, it changes the shape of hemoglobin, making it easier for the other heme groups to bind oxygen as well.
When all four heme groups are bound to oxygen, the resulting molecule is called oxyhemoglobin. As a result, arterial blood...
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Factors Affecting Respiration01:24

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Respiration is a crucial physiological function involving exchanging oxygen (O2) and carbon dioxide (CO2) between an organism and its environment. Various factors can impact this essential process:
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Factors Affecting Erythropoiesis01:24

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The cardiovascular system regulates the number of erythrocytes in the bloodstream to ensure optimal oxygen transport. It also prevents over-proliferation of these cells, which helps to maintain blood viscosity and flow rate.
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EPO then...
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Disorders of Erythrocytes01:27

Disorders of Erythrocytes

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Disorders of erythrocytes, or red blood cells (RBCs), include a range of conditions affecting their number, shape, or function.
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
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On the other...
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Hypoxia01:23

Hypoxia

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Hypoxia is a medical condition characterized by an inadequate oxygen supply to body tissues. It typically manifests as a bluish discoloration of the skin and mucosae, especially in fair-skinned individuals, when hemoglobin (Hb) saturation drops below 75%.
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Updated: May 8, 2025

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
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Hemoglobin decrease predicts untoward outcomes better than severity of anemia.

Brigitta Teutsch1,2,3, Zsolt Abonyi Tóth4,5, Orsolya Ferencz4

  • 1Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary. teutschbrigitta@gmail.com.

Scientific Reports
|December 28, 2024
PubMed
Summary
This summary is machine-generated.

In gastrointestinal bleeding (GIB), a higher relative hemoglobin decrease (ΔHb%) significantly increases adverse outcomes, even above typical transfusion thresholds. This highlights ΔHb% as a critical risk factor in GIB patient management.

Keywords:
Delta hemoglobinHemoglobin decreaseRestrictiveTransfusion

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Area of Science:

  • Gastroenterology
  • Hematology
  • Clinical Medicine

Background:

  • Gastrointestinal bleeding (GIB) patients show varied tolerance to acute blood loss.
  • Assessing patient outcomes in GIB often relies on absolute hemoglobin levels.
  • The impact of the *rate* of hemoglobin decrease on GIB outcomes is not fully understood.

Purpose of the Study:

  • To investigate the effect of relative hemoglobin decrease (ΔHb%) on clinical outcomes in patients with GIB.
  • To determine if ΔHb% is a significant predictor of adverse events in GIB, independent of nadir hemoglobin levels.

Main Methods:

  • Analysis of data from the Hungarian GIB Registry (2019-2022).
  • Patients were categorized into groups based on lowest hemoglobin (nadirHb) and ΔHb%.
  • Primary outcome: composite of in-hospital bleeding-related mortality and urgent intervention.

Main Results:

  • Higher ΔHb% was consistently associated with an increased probability of the composite endpoint, irrespective of nadirHb.
  • A 30-40% ΔHb% decrease to a nadirHb of 80-90 g/L showed similar adverse outcome likelihood as a 0-10% ΔHb% to lower nadirHb levels (70-80 g/L or 60-70 g/L).
  • Increased ΔHb% correlated with adverse outcomes even when nadirHb exceeded recommended transfusion thresholds.

Conclusions:

  • Relative hemoglobin decrease (ΔHb%) is a significant risk factor for adverse outcomes in GIB patients.
  • ΔHb% should be considered alongside nadirHb and transfusion thresholds in clinical decision-making for GIB.
  • Future randomized controlled trials on transfusion strategies in GIB should incorporate ΔHb% as a key variable.