Preopertive and postoperative levels of diphosphoglycerate following elective surgery under general anesthesia.

Diphosphoglycerate (DPG) plays an integral part in the transport of oxygen to tissues. By binding reversibly with hemoglobin, DPG decreases hemoglobin's affinity for oxygen and increases oxygen availability to the tissues. Multiple factors affect the synthesis and binding ability of DPG and indirectly alter oxygen availability to the tissues. General aesthesia imposes many physiologic alterations which, when considered individually, are known to alter DPG levels. The purpose of the present study was to quantify, describe, and compare the preoperative and postoperative measurements of DPG levels in non-acute patients undergoing anesthesia. DPG levels on 30 healthy adults (19 females and 11 males) were obtained before and after elective surgery under general anesthesia. DPG levels decreased from a preoperative mean of 2.34 um-mols/ml to a postoperative mean of 1.83 um-mols/ml (p<.001). This decrease was unrelated to type of anesthetic agent, length of anesthesia, or estimated blood loss. Although actual decreases in tissues oxygenation postoperatively were not measured, some decrease may occur as a result of the decrease in DPG levels. Therefore, nursing measures which promote optimal tissue oxygenation should be directed toward every postoperative patient.