The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 35-39, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Oxygen dissociation after transfusion of blood stored in ACD or CPD solution
F Jesch, LM Webber, JW Dalton and JS Carey
In 20 patients undergoing open-heart surgery, 2,3-diphosphoglycerate
(2,3-DPG) concentrations, oxygen affinity of hemoglobin (Po2 at half
saturation of hemoglobin with oxygen [P50]), hemoglobin concentration, and
pH were measured repeatedly. Measurements were made before and at various
times after open-heart surgery and replacement of blood loss with blood
stored in acid-citrate-dextrose (ACD) or citrate-phosphate- dextrose (CPD)
solutions for less than 72 hours (10 cases per group). Infusion of ACD
blood caused P50 and 2,3-DPG concentration to decrease significantly after
the operation. The infusion of blood stored in CPD did not significantly
increase the oxygen affinity. No significant changes in hemoglobin
concentration or pH were observed immediately after the operation in either
group. To compensate for the increased oxygen affinity, there must be a
rise in cardiac output or more likely a decrease in venous Po2. The
transfusion of CPD blood, therefore, is more favorable in terms of oxygen
supply, particularly in patients who have had cardiac surgery.