Biomaterial Database

Phlebotomy improves pulmonary gas exchange in chronic mountain polycythemia. 1979

J C Cruz, and C Diaz, and E Marticorena, and V Hilario

There is not unanimous agreement in the literature regarding the effects of bleeding on pulmonary gas exchange in polycythemic patients. Spirometry, alveolar arterial O2 and CO2 tension differences, PaO2 breathing 100% oxygen and carbon monoxide-diffusing capacity were measured before and after 1 week of chronic phlebotomy in 4 chronic mountain polycythemic patients. Studies were carried out at 3,700 m above sea level (PB = 491 mm Hg). Before phlebotomy, 2 patients showed abnormal spirometry and gas exchange. Only 1 patient had high PaCO2 and all of them showed low values of PaO2 breathing oxygen. Phlebotomy improved both spirometry and gas exchange. Improvement in arterial oxygen saturation and PaO2 could not be attributed to changes in alveolar ventilation, but rather to better distribution of VA/Qc ratios since physiological dead space decreased. Our results are similar to those reported in polycythemia vera patients. A significant correlation between the changes in PaO2 with phlebotomy and the control PaO2 have been found from 45 polycythemic patients with chronic obstructive pulmonary disease collected from the literature. It is concluded that excessive polycythemia worsened hypoxemia and that phlebotomy improved gas exchange.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008450	Maximal Midexpiratory Flow Rate	Measurement of rate of airflow over the middle half of a FORCED VITAL CAPACITY determination (from the 25 percent level to the 75 percent level). Common abbreviations are MMFR and FEF 25%-75%.	Forced Expiratory Flow 025-075 Percent,FEF 25-75 Percent,Flow Rate, Maximal Midexpiratory,MMFR,25-75 Percent, FEF,25-75 Percents, FEF,FEF 25 75 Percent,FEF 25-75 Percents,Forced Expiratory Flow 025 075 Percent,Percent, FEF 25-75,Percents, FEF 25-75
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010100	Oxygen	An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.	Dioxygen,Oxygen-16,Oxygen 16
D010366	Peak Expiratory Flow Rate	Measurement of the maximum rate of airflow attained during a FORCED VITAL CAPACITY determination. Common abbreviations are PEFR and PFR.	Expiratory Peak Flow Rate,Flow Rate, Peak Expiratory,PEFR
D011086	Polycythemia	An increase in the total red cell mass of the blood. (Dorland, 27th ed)	Erythrocytosis,Erythrocytoses,Polycythemias
D011653	Pulmonary Diffusing Capacity	The amount of a gas taken up, by the pulmonary capillary blood from the alveolar gas, per minute per unit of average pressure of the gradient of the gas across the BLOOD-AIR BARRIER.	Capacity, Pulmonary Diffusing,Diffusing Capacity, Pulmonary
D001815	Bloodletting	Puncture of a vein to draw blood for therapeutic purposes. Bloodletting therapy has been used in Talmudic and Indian medicine since the medieval time, and was still practiced widely in the 18th and 19th centuries. Its modern counterpart is PHLEBOTOMY.
D002245	Carbon Dioxide	A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.	Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic