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Vol. 14. Issue 4.
Pages 149-153 (October - December 1978)
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Vol. 14. Issue 4.
Pages 149-153 (October - December 1978)
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Afinidad de la hemoglobina para el oxigeno en la hipoxemia de los obstructivos
Affinity of hemoblogin for oxygen in hypoxemia of obstructive patients
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L. Palenciano*, M.C. Rodríguez**, F. Payo***, A. de Vega***, M. Corrales***, G. Ocio****
* Jefe Servicio Fisiología Respiratoria. Instituto Nacional de Silicosis. Oviedo
** Médico adjunto Laboratorio de Bioquímica. Instituto Nacional de Silicosis. Oviedo
*** Medico adjunto Fisiología Respiratoria. Instituto Nacional de Silicosis. Oviedo
**** Jefe Laboratorio Clínico. Instituto Nacional de Silicosis. Oviedo
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Se ha estudiado la modificación de la afinidad de la Hb para el 02 en 25 pacientes con obstrucción crónica de vías aéreas en insuficiencia respiratoria (PaO2, ≦ 61mm. de Hg) con pH no inferior a 7,33. Se encontraron elevaciones ligeras, pero significativas, de la concentración intraeritrocitaria de 2,3 DPG. En 19 casos se determinó también la P50 por el método de Aberman y cois., encontrándose un valor medio ligeramente más alto de lo normal. No parece, sin embargo, que estas modificaciones contribuyan apreciablemente a mejorar el transporte de O2 en estos pacientes. Un análisis teórico de la influencia de la afinidad de la Hb muestra que una elevación de la P50 es beneficiosa sólo cuando la PaO2 es normal o más alta de lo normal. Este beneficio se va perdiendo a medida que desciende la PaO2 y puede decirse que es nulo en las hipoxemias severas.

Summary

The authors have studied the modifícation of the affinity of Hb for O2 in 25 patients with chronic obstruction of airways in respiratory insufficiency (PaO2 < 61mmHg.) with a pH not inferior to 7.33. They found slight but signifícant elevations of the intraerythrocytic concentration of 2.3 DPG. The P50 was aiso determined in 19 cases by Aberman and colleagues method. The average valué was slightiy higher than normal. It wouid not seem, however, that these modifications contribute appreciably to improving the transport of O2 in these patients. A theoretical analysis of the influence of the affinity of the Hb shows that an elevation of P50 is beneficial oniy when the PaO2 is normal or higher than normal. This benefit is lost as the PaO2 decreases and it can be said to be nuil in severe hypoxemias.

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Copyright © 1978. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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