Daniel M K, Bennett B, Dawson A A, Rawles J M
Br Med J (Clin Res Ed). 1986 Apr 5;292(6525):923-6. doi: 10.1136/bmj.292.6525.923.
Increasing the haemoglobin concentration results in increased oxygen transport at the cost of increased blood viscosity. This suggested the concept of an optimum packed cell volume for maximising oxygen transport and a study was therefore conducted seeking supportive evidence. Linear cardiac output was measured as minute distance by Doppler ultrasound in 40 patients with haemopoietic disorders who had stable haemoglobin concentrations ranging from 30 to 200 g/l. The correlation between haemoglobin concentration and minute distance (r = -0.45; p less than 0.01) was negative, and correlations between haemoglobin concentration and mean blood pressure (r = 0.66; p less than 0.001) and haemoglobin concentration and peripheral resistance (r = 0.64; p less than 0.001) were positive. Calculated oxygen transport increased across the whole range of haemoglobin values. These results suggest that adjustment of peripheral resistance in response to oxygen availability overrides the influence of blood viscosity on cardiac output and that the optimum packed cell volume for oxygen transport is the highest that can be achieved.
血红蛋白浓度的增加会导致氧运输增加，但代价是血液粘度增加。这就引出了一个关于最佳红细胞压积以实现最大氧运输的概念，因此开展了一项研究以寻找支持性证据。通过多普勒超声测量了40例造血系统疾病患者的线性心输出量，这些患者的血红蛋白浓度稳定在30至200 g/l之间。血红蛋白浓度与每分钟距离之间的相关性（r = -0.45；p < 0.01）为负，而血红蛋白浓度与平均血压之间的相关性（r = 0.66；p < 0.001）以及血红蛋白浓度与外周阻力之间的相关性（r = 0.64；p < 0.001）为正。在整个血红蛋白值范围内，计算得出的氧运输量增加。这些结果表明，根据氧供应情况对外周阻力进行的调节超过了血液粘度对心输出量的影响，并且氧运输的最佳红细胞压积是能够达到的最高值。
