Clinical application of phosphoenolpyruvate (PEP) to autologous transfusion of patients with open heart surgery.
Patients undergoing surgery for cardiac valve replacement were autologously transfused after their cryopreserved blood was treated with phosphoenolpyruvate. Five patients received red cells treated on the day of operation with a solution containing phosphoenolpyruvate, the other 6 serving as a control group. None of the patients received homologous blood. The treated red cells had a normal adenosine triphosphate concentration; in the control group a 10% decrease was noted. The 2,3-bisphosphoglycerate concentration was 211% of normal in red cells of the treated group and 69% of normal in the control group. The P50 values (mmHg) were 31.1 +/- 3.5 (treated), 20.3 +/- 1.7 (untreated), and 26.1 +/- 0.6 (fresh, not cryopreserved), respectively. Both the 2,3-bisphosphoglycerate and P50 values of the circulating blood were significantly (p < 0.02) increased in the patients receiving treated red cells. The increase in the 2,3-bisphosphoglycerate and P50 remained for 6 hours after transfusion at which time the levels of the 2,3-bisphosphoglycerate were 14.5 +/- 2.2 mumol/gHb (treated group) and 10.5 +/- 0.8 mumol/gHb (control group). Those of P50 were 28.1 +/- 1.5 mmHg (treated group) and 25.9 +/- 0.9 mmHg (control group). The adenosine triphosphate levels were not significantly different. The postoperative values of pH and hematocrit did not differ between the two groups. It was estimated that the oxygen delivery capacity in the circulating blood was about 30% higher in the patients receiving phosphoenolpyruvate treated blood than in those receiving untreated blood.
Matsuzaki
K
K
Department of Cardiovascular Surgery, Matsuyama Red Cross Hospital.
Takano
H
H
Tokunaga
K
K
Inaba
S
S
Hamasaki
N
N
D000328:Adult; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D006348:Cardiac Surgical Procedures; D015925:Cryopreservation; D004910:Erythrocyte Membrane / Q000378:metabolism; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010728:Phosphoenolpyruvate / Q000493:pharmacokinetics / Q000627:therapeutic use*
D006454:Hemoglobins; D010728:Phosphoenolpyruvate; D010100:Oxygen