Erythrocyte 2,3-diphosphoglycerate depletion associated with hypophosphatemia detected by routine arterial blood gas analysis.
OBJECTIVE
To describe a clinical case where an extremely low erythrocyte 2,3-diphosphoglycerate concentration (2,3-DPG) was discovered by routine blood gas analysis supplemented by computer calculation of derived quantities. The finding of a low 2,3-DPG revealed a severe hypophosphatemia.


METHODS
Open uncontrolled study of a patient case.


METHODS
Intensive care observation during 41 days.


METHODS
A 44 year old woman with an abdominal abscess.


METHODS
Surgical drainage, antibiotics and parenteral nutrition.


RESULTS
daily routine blood gas analyses with computer calculation of the hemoglobin oxygen affinity and estimation of the 2,3-DPG. An abrupt decline of 2,3-DPG was observed late in the course coincident with a pronounced hypophosphatemia. The fall in 2,3-DPG was verified by enzymatic analysis.


CONCLUSIONS
2,3-DPG may be estimated by computer calculation of routine blood gas data. A low 2,3-DPG which may be associated with hypophosphatemia causes an unfavorable increase in hemoglobin oxygen affinity which reduces the oxygen release to the tissues.
Larsen
V H
VH
Department of Anesthesiology, Herlev Hospital, University of Copenhagen, Denmark.
Waldau
T
T
Gravesen
H
H
Siggaard-Andersen
O
O
D019794:2,3-Diphosphoglycerate; D000328:Adult; D000465:Algorithms; D001784:Blood Gas Analysis; D004163:Diphosphoglyceric Acids / Q000097:blood*; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D006454:Hemoglobins / Q000032:analysis / Q000737:chemistry; D006801:Humans; D017674:Hypophosphatemia / Q000097:blood* / Q000175:diagnosis*; D010100:Oxygen / Q000032:analysis / Q000097:blood; D010710:Phosphates / Q000097:blood; D012984:Software
D004163:Diphosphoglyceric Acids; D006454:Hemoglobins; D010710:Phosphates; D019794:2,3-Diphosphoglycerate; D010100:Oxygen