Increased oxyhemoglobin affinity after transfusion of stored blood: evidence for circulatory compensation

The effect of change in red cell 2,3-diphosphoglycerate concentration after transfusion of ACD stored blood on arteriovenous oxygen content difference, arteriovenous oxygen tension difference and oxygen consumption was assessed in 15 injured patients in Vietnam. A significant increase in the arteriovenous oxygen tension difference and oxygen consumption was observed at the time of low 2,3-DPG. Change in 2,3-DPG did not correlate, however, with change in either arteriovenous oxygen content difference or venous PO(2). This study suggests that alterations in oxyhemoglobin affinity are effectively compensated, possibly by opening capillaries to increase blood flow to tissues, by reducing the capillary-tissue oxygen gradient to maintain the rate of tissue oxygen extraction, or by increasing cardiac output.