Benefits from improved oxygen delivery of blood in shock therapy

Elevating erythrocyte 2,3-DPG and P50 has been proposed as a means of improving the delivery of oxygen by transfused blood. Fourteen baboons were resuscitated from hemorrhagic shock with either (A) 21-day-old blood with low P50 (20.2 mmHg ± SE 1.4) and 2,3-DPG (1.03 m m/liter ± 0.39), or (B) freshly shed autologous blood incubated 1 hr with pyruvate, inosine, glucose, phosphate, and adenine to elevate P50 (36.9 mmHg ± 1.2) and 2,3-DPG (5.00 m m/liter ± 0.33). Regressions of measured variables against P50 revealed: expected cardiac output down 18% for the observed increase in the P50 of the treated group; oxygen consumption up 9%; arterio-venous oxygen difference up 33%; and cardiac work down 24%. The P50 regression coefficients for these variables were different from zero ( p < 0.05). It is concluded that administering blood with elevated 2,3-DPG and P50 furnished adequate tissue oxygenation at lower cardiac output and cardiac work than did 21-day-old blood.