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. 1974 Aug;180(2):213–220. doi: 10.1097/00000658-197408000-00015

The Left Shifted Oxyhemoglobin Curve in Sepsis: A Preventable Defect

George M Watkins, Alvaro Rabelo, Louis F Plzak, George F Sheldon
PMCID: PMC1343641  PMID: 4842983

Abstract

Nine patients with severe sepsis were studied to determine causes for any alterations in oxygen dissociation. Seven of the patients had oxyhemoglobin curves shifted to the left of expected and diminished DPG levels. These deficiences were not corrected in one case. The other eight patients survived or expired with normal to elevated P50T and DPG levels. In this study, three factors occurring either individually, in concordance, or in sequence were present when P50T was decreased. Correction of these deficiencies lead to normalization and, in one case, exceedingly high P50T and DPG levels. Where hypophosphatemia, acidosis, and transfusion of DPG deficient blood were avoided, no such change occurred. Hypophosphatemia is a common occurrence in the seriously ill patient whether or not hyperalimentation is used and may occur in spite of phosphate supplementation. Blood transfusions with CPD as the preservative are effective in reducing the severity of this disorder by the addition of an inorganic phosphate load. Septic shock itself had no untoward effect on oxygen dissociation. This held true even in the terminal stages of the disease process.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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