Impact of hemoglobin concentration and affinity for oxygen on tissue oxygenation : the case of hemoglobin-based oxygen carriers

In patients undergoing exchange-transfusion with hemoglobin (Hb)-based oxygen (O2) carriers (HBOC), native Hb coexists with newly transfused Hb. The two Hb types share the same arterial and venous PO2, but their affinities for O2 vary. A simple spreadsheet model is described aiming at evaluating the contribution of each Hb type to the overall O2 transport characteristics as a function of the batch Hb concentration and O2 affinity in the HBOC solution, of the fraction of exchange-transfused blood/HBOC, and of the arterial PO2. This model helps to yield a quantitative estimate of how tissues with high or low O2 extraction respond to the changes cited above. The results show that the higher the exchange-transfusion ratio, the O2 transport to tissues becomes progressively impaired. However, this effect is more critical at low batch Hb concentration and high O2 affinity of the HBOC, especially for tissues/organs with high O2 extraction, whereas the arterial PO2 does not appear as critical