Changes of blood oxygen affinity and capacity and red cell 2,3-diphosphoglycerate evoked by exchange transfusions with ACD preserved blood in newborn infants: Their interrelationship and influences on oxygen supply of tissues and erythropoiesis

In 20 newborns and infants suffering from hyperbilirubinemia due to blood group incompatibility and other causes “in vivo” blood oxygen affinity and capacity, acid-base equilibrium, reticulocyte count, and red cell 2,3-diphosphoglycerate (2,3-DPG) were determined before and after exchange transfusion (ET) with ACD preserved blood. Functional and biochemical revival of donor blood occurs in vivo during ET; in vitro revival of comparable extent is observed after THAM buffering of the ACD stored blood prior to ET. Normal properties of adult blood in the recipient infants are reached after 24 hrs. A further increase of 2,3-DPG with the resulting enhanced oxygen releasing ability of hemoglobin occurs within 3 to 6 days. Lateron 2,3-DPG and the oxygen releasing ability are being reduced to subnormal values. The resulting decrease of mixed venous oxygen tension at this time is followed by reticulocytosis. Thus 2,3-DPG can be assumed as a regulator of erythropoiesis. Since our results demonstrate a possibility to manipulate the oxygen carrying characteristics of blood of the newborn, factors which are to be considered in states of severe shunt hypoxemia are outlined.