A consistent and organized transition from embryonic to fetal to adult hemoglobin (Hgb) occurs during human fetal development. Hgb concentrations gradually increase, averaging 18 g/dL (180 g/L) by 40 weeks' gestation. The ability to deliver oxygen to tissues in the fetus and neonate is primarily determined by the percentage of fetal versus adult Hgb and the concentration of 2,3 diphosphoglycerate (2,3-DPG). Studies continue to evaluate the relationship between Hgb concentrations and oxygen delivery in neonates to determine what Hgb concentrations best meet the needs of a wide variety of clinical situations from the critically ill extremely low-birthweight infant to the stable growing preterm infant. Biochemical interactions between nitric oxide (NO) and Hgb beyond the production of methemoglobin do occur and may be a source of deliverable NO to the microcirculation under hypoxic conditions.
Core Concepts: The Biology of Hemoglobin
Dr Ohls has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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Robin K. Ohls; Core Concepts: The Biology of Hemoglobin. Neoreviews January 2011; 12 (1): e29–e38. https://doi.org/10.1542/neo.12-1-e29
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