1/2/2023 0 Comments Affinity pediatrics![]() ![]() ![]() Therefore, it is important to consider alternative, albeit rare, diagnoses, including hemoglobinopathies with abnormal oxygen binding properties. When this evaluation is unrevealing, other interventions may be tried without clear benefit to the patient, including, but not limited to, supplemental oxygen. The diagnostic evaluation for neonatal hypoxemia can be invasive and expensive. The differential diagnoses for reduced peripheral oxygen saturation in an infant include congenital heart disease, respiratory distress syndrome, transient tachypnea of the newborn, persistent pulmonary hypertension of the newborn, meconium aspiration syndrome, pneumonia, pneumothorax, and sepsis. Depletion of the red cells ATP by incubation with iodoacetate inhibits the effects of propranolol, indicating its possible interference with membrane phosphorylation.Pulse oximetry is routinely used in the newborn nursery for clinical monitoring and to detect critical congenital heart disease. This morphological change is not associated with the propranolol induced potassium loss and therefore not a result of the concomittantly occurring loss of cell volume. Further, propranolol, a membrane active drug modifies the disc shape of erythrocytes (cupping). Using a new method to monitor rapid and small changes in oxygen affinity of intact red blood cells, it is shown that almost the whole effect of propranolol in decreasing the oxygen affinity is attributable to a decrease in intracellular pH. ![]() Since both intraery-throcytic pH and potassium concentration decrease upon propranololtreatment, the change in oxygen affinity could be based on the Bohr-effect or alternatively due to an increased binding of 2,3-diphosphoglycerate to hemoglobin, secondary to a decrease in intracellular ion-concentration. Propranolol, a β-adrenergic blocker, is known to decrease the hemoglobin oxygen affinity in concentrations 5 to 10 fold the therapeutic level. ![]()
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