دورية أكاديمية
أعرض في EDS

Hemoglobin Is a Vital Determinant of Arterial Oxygen Content in Hypoxemic Patients with Pulmonary Arteriovenous Malformations.

التفاصيل البيبلوغرافية
العنوان: Hemoglobin Is a Vital Determinant of Arterial Oxygen Content in Hypoxemic Patients with Pulmonary Arteriovenous Malformations.
المؤلفون: Rizvi A; 1 School of Medicine, Imperial College London., Macedo P; 2 Respiratory Medicine, Imperial College Healthcare NHS Trust., Babawale L; 2 Respiratory Medicine, Imperial College Healthcare NHS Trust., Tighe HC; 2 Respiratory Medicine, Imperial College Healthcare NHS Trust., Hughes JMB; 3 Respiratory Sciences, National Heart and Lung Institute, Imperial College London., Jackson JE; 4 Imaging, Imperial College Healthcare NHS Trust; and., Shovlin CL; 5 Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
المصدر: Annals of the American Thoracic Society [Ann Am Thorac Soc] 2017 Jun; Vol. 14 (6), pp. 903-911.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Thoracic Society Country of Publication: United States NLM ID: 101600811 Publication Model: Print Cited Medium: Internet ISSN: 2325-6621 (Electronic) Linking ISSN: 23256621 NLM ISO Abbreviation: Ann Am Thorac Soc Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : American Thoracic Society, [2013]-
مواضيع طبية MeSH: Anemia/*blood , Arteriovenous Malformations/*complications , Arteriovenous Malformations/*therapy , Hemoglobins/*analysis , Hypoxia/*blood, Adult ; Blood Gas Analysis ; Embolization, Therapeutic ; Female ; Humans ; Iron/blood ; London ; Lung/blood supply ; Male ; Middle Aged ; Multivariate Analysis ; Oximetry ; Oxygen/blood ; Pregnancy ; Prospective Studies ; Pulmonary Artery/abnormalities ; Pulmonary Veins/abnormalities ; Regression Analysis
مستخلص: Rationale: Pa O 2 and Sa O 2 are commonly measured in respiratory practice, but arterial oxygen content (Ca O 2 ) refers to the volume of oxygen delivered to the tissues per unit blood volume. Ca O 2 is calculated from Sa O 2 and the hemoglobin concentration in blood, recognizing that each gram of hemoglobin can transport approximately 1.34 ml of oxygen when fully saturated.
Objectives: To prospectively evaluate serial changes in Ca O 2 in humans, incorporating and excluding dynamic changes to oxygenation and hemoglobin parameters that may occur during life.
Methods: A cohort of 497 consecutive patients at risk of both hypoxemia and anemia were recruited. The patients had radiologically proven pulmonary arteriovenous malformations (PAVMs), which result in hypoxemia due to right-to-left shunting, and concurrent hereditary hemorrhagic telangiectasia, which placed them at risk of iron deficiency anemia due to recurrent hemorrhagic iron losses. Presentation Sa O 2 (breathing room air, by pulse oximetry), hemoglobin, red cell and iron indices were measured, and Ca O 2 calculated as Sa O 2  × hemoglobin × 1.34 ml/g. Serial measurements were evaluated in 100 cases spanning up to 32.1 (median, 10.5) years.
Results: Presentation Ca O 2 ranged from 7.6 to 27.5 (median, 17.6) ml/dl. Ca O 2 did not change appreciably across the Sa O 2 quartiles. In contrast, hemoglobin ranged from 5.9 to 21.8 g/dl (median, 14.1 g/dl), with a linear increase in Ca O 2 across hemoglobin quartiles. After PAVM embolization and an immediate increase in Sa O 2 , hemoglobin fell and Ca O 2 was unchanged 1.6-12 (median, 4) months later. When hemoglobin fell because of iron deficiency, there was no change in Sa O 2 . Similarly, when hemoglobin rose after iron treatment, there was no change in Sa O 2 , and the expected Ca O 2 increment was observed. These relationships were not evident during pregnancy when hemoglobin fell, and PAVMs usually deteriorated: in pregnancy Sa O 2 commonly increased, and serial Ca O 2 values (incorporating hemodilution/anemia) more accurately reflected deteriorating PAVM status. An apparent fall in Ca O 2 with age in females was attributable to the development of iron deficiency. There was an unexplained increase in Ca O 2 with age in follow-up of males after embolization.
Conclusions: Hemoglobin/Ca O 2 should be further incorporated into oxygenation considerations. More attention should be given to modest changes in hemoglobin that substantially modify Ca O 2 .
فهرسة مساهمة: Keywords: aging; anemia; hemorrhage; iron; pregnancy
المشرفين على المادة: 0 (Hemoglobins)
E1UOL152H7 (Iron)
S88TT14065 (Oxygen)
تواريخ الأحداث: Date Created: 20170308 Date Completed: 20180419 Latest Revision: 20180419
رمز التحديث: 20240628
DOI: 10.1513/AnnalsATS.201611-872OC
PMID: 28267932
قاعدة البيانات: MEDLINE
الوصف
تدمد:2325-6621
DOI:10.1513/AnnalsATS.201611-872OC