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KMID : 0352519850220030329
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Korea Univercity Medical Journal
1985 Volume.22 No. 3 p.329 ~ p.340
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Changes in 2,3-Diphosphoglycerate and Plasma Inorganic Phosphate Concentration after Open Heart Surgery
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Abstract
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Benesch and Benesch demonstrated that hemoglobin affinity for oxygen is :aversely related to the level of red blood cell 2, 3-diphosphoglycerate, an increase of this substance leading to a decreased affinity of hemoglobin for oxygen. With decreased affinity, wtyhernoglobin releases an increased percentage of oxygen to the tissue at any given oxygen tension. The concentration of plasma phosphate has been a factor to change the concentration of 2, 3-DPG.
In heart disease, the increased 2, 3-DPG concentration is noted as a compensation for decreased tissue oxygen availability. The concentration of 2, 3-DPG is influenced by open heart surgery and plasma inorganic phosphate concentration. Plasma inorganic phosphate concentration is also affected by open heart surgery.
To clarify the extent and duration of falling in 2, 3-DPG and phosphate concentration under open heart surgery, this study was performed. Twenty one patients for open heart surgery were divided into two group. One group was a cyanotic patient group. The other group was an acyanotic patient group. Blood samples were collected preoperatively and half day, 1, 2, 3, and 4 days postoperatively. The levels of 2, 3-DPG were measured by ultraviolet enzymatic method of Sigma Chemical Company. Plasma inorganic phosphate level was measured by Spectrophotometer (JASCO UVIDEC-77).
The results were as follows;
1. Preoperative mean value of 2, 3-DPG was 32.46.9pm01/gm in cyanotic heart disease patients, and 22.85.9ttmol/gm in acyanotic heart disease patients. There was a significant difference between the two groups.
2. In cyanotic patients, preoperative 2, 3-DPG ´concentration had fallen significantly to 18. 5 3. Opmol/ gm by 12 hours after surgery, in acyanotic patients to 14.43.5umol/gm significantly.
By the 3rd day, red blood cell 2, 3-DPG had increased in both groups, but was still below preoperative level.
3. Preoperative mean value of plasma inorganic phosphate was 3.530.69mgio in cyanotic group, and 3.910.60mg% in acyanotic group, but there was no significant difference between the two groups.
4. In cyanotic patients significant decrease of preoperative phosphate value was found only in 12 hours after surgery-value (2.380.76mg%). In acyanotic patients, significant decrease was found in 12 hours postoperative value (2.520 *67mg%), 2nd day postoperative value (3.260.61mgo), and 3rd day postoperative value (2.790.56mg,o).
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