| Delaying blood transfusion in experimental acute anemia with a perfluorocarbon emulsion. | |
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MedLine Citation:
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PMID: 21326091 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To avoid unnecessary blood transfusions, physiologic transfusion triggers, rather than exclusively hemoglobin-based transfusion triggers, have been suggested. The objective of this study was to determine systemic and microvascular effects of using a perfluorocarbon-based oxygen carrier (PFCOC) to maintain perfusion and oxygenation during extreme anemia. METHODS: The hamster (weight, 55-65 g) window chamber model was used. Two isovolemic hemodilution steps were performed using hydroxyethyl starch, 10%, at normoxic conditions to a hematocrit of 19% (hemoglobin, 5.5 g/dl), the point at which the transfusion trigger was reached. Two additional hemodilution exchanges using the PFCOC (Oxycyte) and increasing the fraction of inspired oxygen to 1.0 were performed to reduce the hematocrit to 11% (hemoglobin, 3.8 g/dl) and 6% (hemoglobin, 2.0 g/dl), respectively. No control group was used in the study because this concentration of hemodilution is lethal with conventional plasma expanders. Systemic parameters, microvascular perfusion, functional capillary density, and oxygen tensions across the microvascular network were measured. RESULTS: At 6% hematocrit, the PFCOC maintained mean arterial pressure, cardiac output, systemic oxygen delivery, and oxygen consumption. As hematocrit was decreased from 11% to 6%, functional capillary density, calculated microvascular oxygen delivery, and oxygen consumption decreased; and the oxygen extraction ratio was close to 100%. Peripheral tissue oxygenation was not predicted by systemic oxygenation. CONCLUSIONS: The PFCOC, in conjunction with hyperoxia, was able to sustain organ function and partially provide systemic oxygenation during extreme anemia during the observation period. The PFCOC can work as a bridge until erythrocytes are available for transfusion or when additional oxygen is required, despite the possible limitations in peripheral tissue oxygenation. |
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Authors:
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Pedro Cabrales; Juan Carlos Briceño |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 114 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-23 Completed Date: 2011-05-20 Revised Date: 2012-04-04 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 901-11 Citation Subset: AIM; IM |
Affiliation:
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Department of Bioengineering, University of California, San Diego, La Jolla, California 92093-0412, USA. pcabrales@ucsd.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Anemia / blood, drug therapy* Animals Biological Transport Blood Substitutes / therapeutic use* Blood Transfusion Cricetinae Disease Models, Animal Fluorocarbons / therapeutic use* Male Oxygen / blood* Oxygen Consumption Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL062318-04/HL/NHLBI NIH HHS; R01 HL062354-08/HL/NHLBI NIH HHS; R01 HL064395-10/HL/NHLBI NIH HHS; R01-HL62318/HL/NHLBI NIH HHS; R01-HL62354/HL/NHLBI NIH HHS; R24 HL064395-05/HL/NHLBI NIH HHS; R24-HL64395/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Substitutes; 0/Fluorocarbons; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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