Increased red cell osmotic fragility and hematocrit after hyperbaric O2 exposure are related to acidosis

Exposure to hyperbaric O2 (0.6 MPa) until convulsion occurred resulted in increased red blood cell osmotic fragility, increased hematocrit, and acidosis. Correction of the mixed metabolic and respiratory acidosis in arterial blood samples completely restored osmotic fragility and lowered hematocrit by 20%. Rats exposed to intermittent hyperbaric O2 (repeated cycles of 7 minutes of O2 and 7 minutes of air) tolerated significantly more O2 time than those exposed continuously. Intermittently exposed animals had smaller increases in osmotic fragility and less-severe acidosis. We verified the influence of pH on osmotic fragility and hematocrit in rats made acutely acidotic and corrected in vivo. Acidosis caused by CO2 inhalation and lactic and hydrochloric acid infusion raised osmotic fragility and hematocrit; these effects were completely reversed in the animal when we restored normal acid-base status. These studies demonstrate that conditions causing acidosis, including hyperbaric O2 exposure, increase red cell fragility and size and increase hematocrit.