ERYTHROCYTE 2,3-DIPHOSPHOGLYCERATE DEPLETION ASSOCIATED WITH HYPOPHOSPHATEMIA DETECTED BY ROUTINE ARTERIAL BLOOD-GAS ANALYSIS

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.