Optimized hyperventilation preserves 2,3-diphosphoglycerate in severe traumatic brain injury

Abstract

ABSTRAT -Introduction:The concentration of 2,3-diphosphoglycerate (2,3-DPG/Hct) increases as a physiological occurrence to pH increase and hyperventilation. This response was tested in patients with severe traumatic brain injury (TBI). Method: The concentration of 2,3-DPG/Hct was measured daily for six days in eleven patients with severe TBI in need of optimized hyperventilation because of intracranial hypertension. Results: There was correlation between pH and the concentration of DPG/Hct. The concentration of 2,3-DPG/Hct remained predominantly within normal levels with slight increase in the sixth day of the study. The concentration of 2,3-DPG/Hct correlated significantly with measured partial pressure of oxygen that saturates 50% the hemoglobin of the blood (P50st), confirming the consistency of our data. Conclusion: The expected physiological response of a progressive increase in concentration of 2,3-DPG/Hct to hyperventilation was not observed. This fact may be explained by the intermittent and not sustained hyperventilation as dictated by the protocol of optimized ventilation.

Avaliação da concentração de 2,3-difosfoglicerato, homocisteina plasmatica, acido folico, vitamina B12 e polimorfismos no gene da MTHFR em pacientes com doença pulmonar obstrutiva cronica

“…A hipofosfatemia pode causar queda na concentração de 2,3-DPG devido a diminuição de 1,3-DPG, levando ao aumento da degradação de 2,3-DPG e a hiperfosfatemia provoca o efeito contrário (CLERBAUX et. al., 2006;TORRES et. al., 2007).…”

“…Em humanos, o 2,3-DPG apresenta concentração equimolar à hemoglobina nos eritrócitos (BENECH e BENECH, 1969;POMPONI et. al., 2001;TORRES et. al., 2007).…”

“…Os principais fatores que regulam a concentração de 2,3-DPG nos eritrócitos são alterações no pH intra-eritrocitário e hipóxia (TORRES et. al., 2007).…”