Hemoglobin concentration, total hemoglobin mass and plasma volume in patients: implications for anemia
James M. Otto,
James O.M. Plumb,
Eleri Clissold,
Shriya B. Kumar,
Denis J. Wakeham,
Walter Schmidt,
Michael P.W. Grocott,
Toby Richards,
Hugh E. Montgomery
Affiliations
James M. Otto
Division of Surgery and Interventional Science, University College London, UK
James O.M. Plumb
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK;Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
Eleri Clissold
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK;Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
Shriya B. Kumar
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK;Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
Denis J. Wakeham
School of Sport, Physiology and Health Group, Cardiff Metropolitan University, UK
Walter Schmidt
Department of Sports Medicine/Sports Physiology, University of Bayreuth, Germany
Michael P.W. Grocott
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK;Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK;Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
Toby Richards
Division of Surgery and Interventional Science, University College London, UK
Hugh E. Montgomery
Centre for Human Health and Performance/Institute of Sport, Exercise and Health, University College London, and NIHR University College London Hospitals Biomedical Research Centre, UK
In practice, clinicians generally consider anemia (circulating hemoglobin concentration < 120 g.l−1 in non-pregnant females and < 130 g.l−1 in males) as due to impaired hemoglobin synthesis or increased erythrocyte loss or destruction. Rarely is a rise in plasma volume relative to circulating total hemoglobin mass considered as a cause. But does this matter? We explored this issue in patients, measuring hemoglobin concentration, total hemoglobin mass (optimized carbon monoxide rebreathing method) and thereby calculating plasma volume in healthy volunteers, surgical patients, and those with inflammatory bowel disease, chronic liver disease or heart failure. We studied 109 participants. Hemoglobin mass correlated well with its concentration in the healthy, surgical and inflammatory bowel disease groups (r=0.687–0.871, P
