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. 1977 Jun;32(3):317–321. doi: 10.1136/thx.32.3.317

Secondary polycythaemia in chronic respiratory insufficiency.

D Vanuxem, C Guillot, E Fornaris, P J Weiller, C Grimaud
PMCID: PMC470608  PMID: 882946

Abstract

The relationship between polycythaemia, P50 and SaCO (saturation in carboxyhaemoglobin) has been studied in 50 patients who were hypoxaemic due to chronic respiratory insufficiency. These patients were divided into two groups according to their haemoglobin concentration and haematocrit: 21 polycythaemic patients with haemoglobin greater than or equal to 16 g/dl and haematocrit greater than or equal to 50% and 29 patients without polycythaemia. PaO2, PaCO2, plasma and erythrocyte pH, haemoglobin, haematocrit, and carbon monoxide saturation and intraerythrocytic 2-3 diphosphoglycerate concentration were measured during steady-state ventilation. All polycythaemic patients were smokers and their carbon level was significantly higher than that observed in patients without polycythaemia. Additionally, their P50 and 2-3 DPG concentration were significantly lower than in patients without polycythaemia. The correlations between P50 and HbCO and between Hb and HbCO were significant (r=--0-672; r=0-552 respectively: P less than 0-001). Eleven non-polycythaemic patients who were smokers had a high level of HbCO but normal P50. A group of 29 normoxic subjects was also studied, 14 non-smokers and 15 smokers with a high HbCO level. The mean value of P50 was lower in smokers and their haematocrit was higher although the difference was not significant for the latter. The HbCO increase by tobacco seems to be a factor in the occurrence of polycythaemia in patients with chronic respiratory insufficiency. The level of increase of HbCO and/or its duration and perhaps other individual factors and explain why all patients with high HbCO level and hypoxaemia were not polycythaemic.

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Selected References

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

  1. Adamson J. W., Finch C. A. Hemoglobin function, oxygen affinity, and erythropoietin. Annu Rev Physiol. 1975;37:351–369. doi: 10.1146/annurev.ph.37.030175.002031. [DOI] [PubMed] [Google Scholar]
  2. Asakura T., Sato Y., Minakami S., Yoshikawa H. Effect of deoxygenation of intracellular hemoglobin on red cell glycolysis. J Biochem. 1966 May;59(5):524–526. doi: 10.1093/oxfordjournals.jbchem.a128337. [DOI] [PubMed] [Google Scholar]
  3. Astrup P., Hellung-Larsen P., Kjeldsen K., Mellemgaard K. The effect of tobacco smoking on the dissociation curve of oxyhemoglobin. Investigations in patients with occlusive arterial diseases and in normal subjects. Scand J Clin Lab Invest. 1966;18(4):450–457. doi: 10.3109/00365516609113166. [DOI] [PubMed] [Google Scholar]
  4. BARTELS H., HARMS H. Sauerstoffdissoziationskurven des Blutes von Säugetieren (Mensch, Kaninchen, Meerschweinchen, Hund, Katze, Schwein, Rind und Schaf. Pflugers Arch. 1959;268(4):334–365. doi: 10.1007/BF00380734. [DOI] [PubMed] [Google Scholar]
  5. Bellingham A. J., Detter J. C., Lenfant C. Regulatory mechanisms of hemoglobin oxygen affinity in acidosis and alkalosis. J Clin Invest. 1971 Mar;50(3):700–706. doi: 10.1172/JCI106540. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cole P. V. Comparative effects of atmospheric pollution and cigarette smoking on carboxyhaemoglobin levels in man. Nature. 1975 Jun 26;255(5511):699–701. doi: 10.1038/255699a0. [DOI] [PubMed] [Google Scholar]
  7. EISEN M. E., HAMMOND E. C. The effect of smoking on packed cell volume, red blood cell counts, haemoglobin and platelet counts. Can Med Assoc J. 1956 Sep 15;75(6):520–523. [PMC free article] [PubMed] [Google Scholar]
  8. FRIED W., GOLDWASSER E., JACOBSON L. O., PLZAK L. F. Studies on erythropoiesis. III. Factors controlling erythropoietin production. Proc Soc Exp Biol Med. 1957 Jan;94(1):237–241. doi: 10.3181/00379727-94-22910. [DOI] [PubMed] [Google Scholar]
  9. Goldsmith J. R., Landaw S. A. Carbon monoxide and human health. Science. 1968 Dec 20;162(3860):1352–1359. doi: 10.1126/science.162.3860.1352. [DOI] [PubMed] [Google Scholar]
  10. MURRAY J. F. ARTERIAL STUDIES IN PRIMARY AND SECONDARY POLYCYTHEMIC DISORDERS. Am Rev Respir Dis. 1965 Sep;92:435–449. doi: 10.1164/arrd.1965.92.3.435. [DOI] [PubMed] [Google Scholar]
  11. Morena H., Yacoub M., Maurel F., Faure J., Mallion J. M. Variations de la teneur en 2,3-diphosphoglycérate érythrocytaire au cours de l'intoxication oxycarbonée expérimentale. Implications physiopathologiques. Eur J Toxicol Environ Hyg. 1974 Jan;7(1):37–45. [PubMed] [Google Scholar]
  12. RUSSELL R. P., CONLEY C. L. BENIGN POLYCYTHEMIA: GAISBOECK'S SYNDROME. Arch Intern Med. 1964 Dec;114:734–740. doi: 10.1001/archinte.1964.03860120046002. [DOI] [PubMed] [Google Scholar]
  13. Robert M. Affinité de l'hémoglobine pour l'oxygène. Bull Physiopathol Respir (Nancy) 1975 Jan-Feb;11(1):79–170. [PubMed] [Google Scholar]
  14. Russell M. A., Cole P. V., Brown E. Absorption by non-smokers of carbon monoxide from room air polluted by tobacco smoke. Lancet. 1973 Mar 17;1(7803):576–579. doi: 10.1016/s0140-6736(73)90718-6. [DOI] [PubMed] [Google Scholar]
  15. Sagone A. L., Jr, Balcerzak S. P. Smoking as a cause of erythrocytosis. Ann Intern Med. 1975 Apr;82(4):512–515. doi: 10.7326/0003-4819-82-4-512. [DOI] [PubMed] [Google Scholar]
  16. Sagone A. L., Jr, Lawrence T., Balcerzak S. P. Effect of smoking on tissue oxygen supply. Blood. 1973 Jun;41(6):845–851. [PubMed] [Google Scholar]
  17. Vanuxem D., Fornaris E., Delpierre S., Grimaud C. Role de l'équilibre acido-basique dans les modifications de l'affinité de l'hémoglobine pour l'oxygène dans l'hypoxémie artérielle. Bull Physiopathol Respir (Nancy) 1975 May-Jun;11(3):305–314. [PubMed] [Google Scholar]
  18. Vanuxem D., Vanuxem P., Jammes Y., Nicoli M. M., Delpierre S., Grimaud C. Incidence du tabac sur le transport de l'oxygène par le sang. C R Seances Soc Biol Fil. 1973;167(11):1610–1614. [PubMed] [Google Scholar]

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