[The critical hemoglobin value in newborn infants, infants and children].
[The critical hemoglobin value in newborn infants, infants and children].
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新生儿、婴儿和儿童的临界血红蛋白值。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
G. Zilow
中科院分区：
文献类型：
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作者：
O. Linderkamp;E. Zilow;G. Zilow
最佳和临界血红蛋白浓度由组织的需氧量和几个氧运输参数（即，血流量、动脉氧饱和度、血红蛋白的氧亲和力和临界静脉氧压）。大多数氧转运参数在出生后的第一周内发生显著变化。新生儿的耗氧量和心输出量是成年人体重的三倍。由于胎儿血红蛋白的高氧亲和力，新生儿血红蛋白的氧卸载能力比成人低约50%。从氧转运参数和耗氧量，我们计算出的最佳和临界血红蛋白浓度早产儿和足月新生儿在出生后的第一周。血红蛋白浓度为15 g/dl似乎是早产儿和足月婴儿出生时以及成人的最佳值。计算的最低可接受血红蛋白浓度为6 g/dl（儿童和成人）、12 g/dl（早产儿）和11 g/dl（足月新生儿）。由于出生后氧亲和力降低，最低可接受血红蛋白浓度在前5-6周降低约1 g/dl/周，直到儿童和成人达到6 g/dl的最低值。对于需要增加氧气或患有其他严重疾病的患者，最低血红蛋白浓度应高出2 g/dl。对于患有白血病或其他肿瘤疾病的儿童，建议最低血红蛋白浓度为10 g/dl。在患有慢性低氧血症（紫绀型先天性心脏病）的婴儿和儿童中，最低血红蛋白浓度应增加动脉血氧饱和度下降的百分比。
The optimum and critical hemoglobin concentrations are determined by the oxygen demand of the tissues and several oxygen transport parameters (i.e., blood flow, arterial oxygen saturation, oxygen affinity of hemoglobin, and the critical venous oxygen pressure). Most of the oxygen transport parameters change markedly during the first weeks after birth. Oxygen consumption and cardiac output in neonates are three times those of adults on a body weight basis. Due to the high oxygen affinity of fetal hemoglobin, the oxygen unloading capacity of hemoglobin in neonates is about 50% less than in adults. From oxygen transport parameters and oxygen consumption we have calculated the optimum and the critical hemoglobin concentrations for preterm and full-term neonates during the first weeks after birth. A hemoglobin concentration of 15 g/dl appears optimal for preterm and full-term infants at birth as well as for adults. The calculated minimum acceptable hemoglobin concentration is 6 g/dl for children and adults, 12 g/dl for preterm infants and 11 g/dl for full-term neonates at birth. Due to the postnatal decrease in oxygen affinity, the minimum acceptable hemoglobin concentration decreases by approximately 1 g/dl/week for the first 5-6 weeks until the minimum value of 6 g/dl for children and adults is reached. The minimum hemoglobin concentration should be 2 g/dl higher in patients who require increased oxygen or suffer from other serious disorders. A minimum hemoglobin concentration of 10 g/dl is recommended in children with leukemia or other oncological disease. In infants and children with chronic hypoxemia (cyanotic congenital heart disease) the minimum hemoglobin concentration should be increased by the percentage of arterial oxygen desaturation.