• Simon Woyke, Marco Ronzani, Norbert Mair, Christoph Frisch, Katharina Marcher, Thomas Haller, Mathias Ströhle, and Christopher Rugg.
• Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
• J Crit Care. 2024 Sep 18; 85: 154916154916.

BackgroundHemoglobin‑oxygen (Hb-O2) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O2 affinity.MethodsIn this experimental ex-vivo trial, venous blood samples were taken from 5 male and 6 female volunteers and incubated with the particular cardiovascular agents. Oxygen dissociation curves (ODC) were measured in-vitro with a new high-throughput method.ResultsCompared to the P50 in male and female controls, a significant right-shift of the ODC was found for noradrenaline and milrinone in all participants and for levosimendan in male samples only. Adrenaline decreased Hb-O2 affinity in male samples, atropine in female samples only.DiscussionAll investigated agents decreased Hb-O2 affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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