Red-Cell 2,3-Diphosphoglycerate and Creatine Levels in Patients with Red-Cell Mass Deficits or with Cardiopulmonary Insufficiency

Since the organic phosphate compounds, ATP (adenosine triphosphate) and 2,3-DPG (2,3-diphosphoglycerate), facilitate the release of oxygen from hemoglobin, the concentration of these compounds in the red cell may change in an attempt to compensate for any impairment in oxygen supply to tissue. We have observed elevated levels of red-cell 2,3-DPG and creatine in patients suffering from red-cell mass deficits and cardiopulmonary insufficiency; a significant correlation was noted between levels of red-cell 2,3-DPG and creatine. The mechanisms responsible for these elevations, however, are not known. Our data suggest that assays of the levels of peripheral red-cell 2,3-DPG and creatine constitute an excellent functional biopsy for evaluation of the state of tissue oxygenation. Such assays are useful for diagnosis and serial evaluation of therapy in patients with red-cell mass deficits and should be helpful in patients with cardiopulmonary disease.