FRANK A. OSKI, M.D.; BRYAN E. MARSHALL, M.D.; PETER J. COHEN, M.D.; HARVEY J. SUGERMAN, M.D.; LEONARD D. MILLER, M.D.
Two patients with similar degrees of anemia, one with a left-shifted and one with a right-shifted oxygen-hemoglobin equilibrium curve, were exercised on a bicycle ergometer. The patient with the left-shifted curve, at minimal exercise, demonstrated a prompt fall in central venous oxygen tension. Exercise, with its increased needs for oxygen consumption, was accomplished by an increase in cardiac output. The right-shifted individual had a gradual fall in central venous oxygen tension and because of the ability to extract more oxygen did not demonstrate the same degree of cardiac compensation. The position of the oxygen-equilibrium curve, as mediated by red cell 2,3-diphosphoglycerate levels, appears to play a significant role in the anemic patient's adaptation to exercise.
OSKI FA, MARSHALL BE, COHEN PJ, SUGERMAN HJ, MILLER LD. Exercise with Anemia: The Role of the Left-Shifted or Right-Shifted Oxygen-Hemoglobin Equilibrium Curve. Ann Intern Med. ;74:44–46. doi: 10.7326/0003-4819-74-1-44
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Published: Ann Intern Med. 1971;74(1):44-46.
Hematology/Oncology, Red Cell Disorders.
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