Seems erythrocytosis .. too many red blood cells .. and polycythemia .. are ..
the same ..
The marker used to assess polycythemia {too many red blood cells] is set by ..
cost.
The higher the marker {red blood cells] to eliminate 'false positives' ..
So .. do YOU have the iron levels of a pre-menopausal woman?
You know that .. anemic .. one .. ?
THAT is the level research has shown to be the healthiest.
---------------------------------------------------------
Thus, although individuals
at high risk for ASCVD are not Fe-overloaded, they seem to benefit,
metabolically and hemodynamically, from lowering of body Fe to levels commonly
seen in premenopausal females.
PMID: 12079862
--------------------------------------------------------
Chest 1990 Nov;98(5):1073-7
Exercise performance of polycythemic chronic obstructive pulmonary disease
patients. Effect of phlebotomies.
Chetty KG, Light RW, Stansbury DW, Milne N
Department of Medicine, VA Medical Center, Long Beach, CA 90822.
The purpose of this study was to determine the effects of phlebotomy
on the exercise tolerance and right and left ventricular ejection
fraction of polycythemic patients with chronic obstructive pulmonary
disease. Ten patients with COPD (mean FEV1 = 1.32 +/- 0.55 L) and
polycythemia (mean Hct = 62 +/- 3 percent) were studied before and
after their hematocrits had been reduced to approximately 50 percent.
Post-phlebotomy the maximal oxygen consumption increased from 1.09 +/-
0.34 L/min to 1.26 +/- 0.43 L/min (p less than 0.05) and the maximum
workload increased from 56.5 +/- 32.6 watts to 74.5 +/- 23.4 watts (p
less than 0.05). The increase in the exercise tolerance appeared to be
primarily due to an increased cardiac output at Emax. There was no
relationship between the increases in the upright exercise capacity
and changes in the supine ejection fractions of the right or left
ventricular either at rest or during exercise.
PMID: 2225946, UI: 91030710
_________________________________________________________________
Int J Cardiol 1994 Apr;44(2):175-7
Effects of phlebotomy on a patient with secondary polycythemia and angina
pectoris.
Piccirillo G, Fimognari FL, Valdivia JL, Marigliano V
Cattedra di Geriatria e Gerontologia Universita, La Sapienza, Rome,
Italy.
A 67-year-old man with polycythemia, secondary to chronic obstructive
pulmonary disease, had angina attacks at rest treated successfully by
supplementing conventional therapy with frequent phlebotomies.
Although phlebotomy reduces arterial oxygen content, it also decreases
blood viscosity, improves peripheral oxygen consumption and thus
yields the clinical benefit.
PMID: 8045664, UI: 94321077
_________________________________________________________________
Respiration 1979;38(6):305-13
Phlebotomy improves pulmonary gas exchange in chronic mountain polycythemia.
Cruz JC, Diaz C, Marticorena E, Hilario V
There is not unanimous agreement in the literature regarding the
effects of bleeding on pulmonary gas exchange in polycythemic
patients. Spirometry, alveolar arterial O2 and CO2 tension
differences, PaO2 breathing 100% oxygen and carbon monoxide-diffusing
capacity were measured before and after 1 week of chronic phlebotomy
in 4 chronic mountain polycythemic patients. Studies were carried out
at 3,700 m above sea level (PB = 491 mm Hg). Before phlebotomy, 2
patients showed abnormal spirometry and gas exchange. Only 1 patient
had high PaCO2 and all of them showed low values of PaO2 breathing
oxygen. Phlebotomy improved both spirometry and gas exchange.
Improvement in arterial oxygen saturation and PaO2 could not be
attributed to changes in alveolar ventilation, but rather to better
distribution of VA/Qc ratios since physiological dead space decreased.
Our results are similar to those reported in polycythemia vera
patients. A significant correlation between the changes in PaO2 with
phlebotomy and the control PaO2 have been found from 45 polycythemic
patients with chronic obstructive pulmonary disease collected from the
literature. It is concluded that excessive polycythemia worsened
hypoxemia and that phlebotomy improved gas exchange.
PMID: 538338, UI: 80146854
_________________________________________________________________
Am J Med 1983 Mar;74(3):415-20
Improved exercise tolerance of the polycythemic lung patient following
phlebotomy.
Chetty KG, Brown SE, Light RW
The present study evaluated the effects of therapeutic phlebotomy on
the exercise tolerance and the maximal carbon dioxide output of
polycythemic patients with chronic obstructive pulmonary disease.
Fifteen maximal exercise studies were performed before and after
phlebotomy in patients with moderate to severe chronic obstructive
pulmonary disease (mean forced expiratory volume in one second [FEV1]=
970 ml). After phlebotomy there were no significant differences in
pulmonary function, blood gases, oxygen consumption, or carbon dioxide
production at rest. However, after phlebotomy there was a significant
increase in the exercise tolerance of the patients. The mean workload,
the duration of exercise, the maximal oxygen consumption, the maximal
carbon dioxide production, and the ventilation at maximal exercise all
increased significantly. The improved exercise tolerance after
phlebotomy appeared due to an increased cardiac output generated
mainly through an increased stroke volume. We hypothesize that the
increased stroke volume was due to a higher ejection fraction of the
right ventricle secondary to a lower pulmonary artery pressure. This
study provides further evidence that patients with chronic obstructive
pulmonary disease who have polycythemia benefit by therapeutic
interventions that maintain their hematocrits below 55 percent.
PMID: 6402930, UI: 83149913
_________________________________________________________________
Surgery 1980 Nov;88(5):686-92
Increased oxygen uptake following phlebotomy and simultaneous fluid replacement
in polycythemic patients.
Shah DM, Powers SR Jr, Bernard HR, Scovill WA, Newell JC, Stratton HH
To study the isolated effects of decreased hemoglobin concentration
without volume loss, eight patients with the diagnosis of polycythemia
were studied following acute phlebotomy and simultaneous volume
replacement. These patients had been treated previously by repeated
phlebotomy, without volume replacement, to a hemoglobin level of 14.8
+/- 0.5 gm%. Following hemodilution by additional phlebotomy and
volume replacement, which further lowered the mean hemoglobin level to
11.4 +/- 0.4 gm%, cardiac index increased significantly from 2.8 +/-
0.3 to 3.5 +/- 0. 3 liter/min/m(2) (P<0.05), oxygen delivery did not
change, but total body oxygen consumption increased significantly from
140 +/- 16 to 180 +/- 15 ml/min/m(2) (P<0.05). Mixed venous PO2,
systemic and pulmonary vascular resistance decreased significantly
(P<0.05). Vascular pressure, heart rate, intrapulmonary shunt,
arterial pH and bicarbonate, limb blood flow, limb oxygen delivery and
limb oxygen consumption did not change. Thus, with phlebotomy and
fluid replacement, a reduction of hemoglobin concentration to a
subnormal level increased oxygen consumption without lowering oxygen
delivery.
PMID: 7434209, UI: 81056744
_________________________________________________________________
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