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Reducing packed cell volume has been advocated as a therapeutic procedure in patients with polycythaemia secondary to hypoxic cor pulmonale. The aim of this investigation was to evaluate the effects of this manoeuvre on resting pulmonary haemodynamics and tissue oxygenation in 12 such patients. The subjects were studied whilst they were breathing air (n = 12), after breathing 35% oxygen for 30 min (n = 11) and breathing air 30 min after isovolaemic reduction in packed cell volume, from 0.61 +/- 0.02 to 0.50 +/- 0.02 (mean +/- SEM), by erythrapheresis (n = 12). Initial values for the group were: PaO2 6.5 +/- 0.3 kPa; red cell mass 152 +/- 12% predicted; mean pulmonary artery pressure (PAP) 41 +/- 3 mmHg; cardiac index 3.1 +/- 0.31 min-1 m-2. Breathing 35% oxygen reduced PAP by 3.1 +/- 1.0 mmHg (P less than 0.02), cardiac index by 0.28 +/- 0.121 min-1 m-2 (P less than 0.05) and right ventricular stroke work by 0.05 +/- 0.01 J (P less than 0.01). Systemic vascular resistance was unchanged. Systemic oxygen transport increased and peripheral oxygen consumption was unaltered. Erythrapheresis reduced blood viscosity at shear rates 23 S-1 and 230 S-1. PAP fell by 2.4 +/- 1.1 mmHg (P less than 0.05) and cardiac index increased by 0.32 +/- 0.091 min-1 m-2 (P less than 0.01), but right ventricular stroke work was unchanged. Systemic vascular resistance was reduced by 25 +/- 7 kPa S l-1 (P less than 0.01). Systemic oxygen transport decreased but peripheral oxygen consumption was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
January 1986,
Clinical science (London, England : 1979),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
October 1983,
British medical journal (Clinical research ed.),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
January 1984,
British medical journal (Clinical research ed.),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
February 1983,
British medical journal (Clinical research ed.),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
April 1983,
British medical journal (Clinical research ed.),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
January 1986,
Chest,
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
January 1983,
Respiration; international review of thoracic diseases,
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
February 1989,
Wiadomosci lekarskie (Warsaw, Poland : 1960),
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
July 1987,
Kokyu to junkan. Respiration & circulation,
P J Wallis, and
J D Skehan, and
A C Newland, and
J A Wedzicha, and
P G Mills, and
D W Empey
November 1984,
European journal of respiratory diseases,
