section name header

Introduction ⬇

2,3-DPG assists in transporting oxygen from RBCs to body tissues. 2,3-DPG increases in response to hypoxia or anemia and decreases in acidosis. Levels are lower in newborns and even lower in premature newborns.

Normal Findings ⬆ ⬇

Adults: 10.4–14.2 μmol/g Hb or 3.6–4.8 μmol/mL RBCs

Check with your reference laboratory.

Procedure ⬆ ⬇

  1. Obtain a venous blood sample of at least 5 mL, anticoagulated with heparin. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered.

  2. Place on ice immediately (2,3-DPG is stable for only 2 hours) and transport to the laboratory as soon as possible in a biohazard bag.

Clinical Implications ⬆ ⬇

  1. Increased 2,3-DPG occurs in:

    1. Emphysema, cystic fibrosis with pulmonary involvement (conditions of hypoxia)

    2. Cyanotic heart disease

    3. Pulmonary vascular disease

    4. Sickle cell anemia, iron-deficiency anemia

    5. PK deficiency

    6. Hyperthyroidism

    7. CKD

    8. Cirrhosis

  2. Decreased 2,3-DPG occurs in:

    1. Polycythemia vera

    2. Respiratory distress syndrome

    3. 2,3-DPG deficiency

    4. Hexokinase deficiency

Interventions ⬆ ⬇

Pretest Patient Care for Tests for Hemolytic Anemia

  1. Explain test purpose and procedure. There should be no exercising before tests.

  2. Withhold transfusion until after blood samples are drawn (especially with osmotic fragility).

  3. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care for Tests for Hemolytic Anemia

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment. Monitor for hemolytic anemia, hypoxia, or polycythemia.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Interfering Factors ⬆

  1. High altitude increases 2,3-DPG.

  2. Exercise increases 2,3-DPG.

Clinical Alert

If blood with decreased 2,3-DPG is used for transfusion, the Hb may not release O2 when needed