Objective: to describe a clinical case where an extremely low erythroc
yte 2,3-diphosphoglycerate concentration (2,3-DPG) was discovered by r
outine blood gas analysis supplemented by computer calculation of deri
ved quantities. The finding of a low 2,3-DPG revealed a severe hypopho
sphatemia. Design: open uncontrolled study of a patient case. Setting:
intensive care observation during 41 days. Patient: A 44 year old wom
an with an abdominal abscess. Interventions: Surgical drainage, antibi
otics and parenteral nutrition. Measurements and results: daily routin
e blood gas analyses with computer calculation of the hemoglobin oxyge
n affinity and estimation of the 2,3-DPG. An abrupt decline of 2,3-DPG
was observed late in the course coincident with a pronounced hypophos
phatemia. The fall in 2,3-DPG was verified by enzymatic analysis. Conc
lusion: 2,3-DPG may be estimated by computer calculation of routine bl
ood gas data. A low 2,3-DPG which may be associated with hypophosphate
mia causes an unfavorable increase in hemoglobin oxygen affinity which
reduces the oxygen release to the tissues.