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Studies on the haemopoietic toxicity of nitrous oxide in man
Author(s) -
Skacel P. O.,
Hewlett A. M.,
Lewis J. D.,
Lumb M.,
Nunn J. F.,
Chanarin I.
Publication year - 1983
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1983.00097.x-i1
Subject(s) - bone marrow , medicine , toxicity , myeloid leukaemia , haematopoiesis , methionine , peripheral blood , nitrous oxide , myeloid , vitamin e , endocrinology , physiology , gastroenterology , biology , anesthesia , biochemistry , antioxidant , stem cell , genetics , amino acid
S ummary . Nitrous oxide inactivates vitamin Bi 2 and in man can produce a megaloblastic anaemia. Haematological and biochemical changes were studied in nine surgical patients ventilated with 70% N 2 0 for up to 24 h and in three control patients. There was a rise in the numbers of hypersegmented neutrophils in peripheral blood following N2O. Serial bone marrow aspirates showed gross megaloblastic change after 24 h of N 2 0 which had reverted to normoblastic but dyserythropoietic haemopoiesis by 1 week. Giant forms of early myeloid precursors were also seen after 24 h ventilation with N 2 0 but by 1 week abnormalities were evident in more mature cells, metamyelocytes and segmented neutrophils. Megalo‐blastosis was associated with abnormal dU suppression which showed a correction pattern similar to that seen in vitamin Bi 2 deficiency. Administration of N 2 0 was also associated with a progressive rise in serum folate and fall in serum methionine levels. No similar patterns were seen in the three control patients.