Document Detail


Diaspirin cross-linked hemoglobin infusion did not influence base deficit and lactic acid levels in two clinical trials of traumatic hemorrhagic shock patient resuscitation.
MedLine Citation:
PMID:  20145575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Diaspirin cross-linked hemoglobin (DCLHb) has demonstrated a pressor effect that could adversely affect traumatic hemorrhagic shock patients through diminished perfusion to vital organs, causing base deficit (BD) and lactate abnormalities. METHODS: Data from two parallel, multicenter traumatic hemorrhagic shock clinical trials from 17 US Emergency Departments and 27 European Union prehospital services using DCLHb, a hemoglobin-based resuscitation fluid. RESULTS: In the 219 patients, the mean age was 37.3 years, 64% of the patients sustained a blunt injury, 48% received DCLHb resuscitation, and the overall 28-day mortality rate was 36.5%. BD data did not differ by treatment group (DCLHb vs. normal saline [NS]) at any time point. Study entry BD was higher in patients who died when compared with survivors in both studies (US: -14.7 vs. -9.3 and European Union: -11.1 vs. -4.1 mEq/L, p < 0.003) and at the first three time points after resuscitation. No differences in BD based on treatment group were observed in either those who survived or those who died from the hemorrhagic shock. US lactate data did not differ by treatment group (DCLHb vs. NS) at any time point. Study entry lactates were higher in US patients who ultimately died when compared with survivors (82.4 vs. 56.1 mmol/L, p < 0.003) and at all five postresuscitation time points. No lactate differences were observed between DCLHb and NS survivors or in those who died based on treatment group. CONCLUSIONS: Although patients who died had more greatly altered perfusion than those who survived, DCLHb treatment of traumatic hemorrhagic shock patients was not associated with BD or lactate abnormalities that would indicate poor perfusion.
Authors:
Edward P Sloan; Max D Koenigsberg; Nora B Philbin; Weihua Gao; ;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  68     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1158-71     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois 60612, USA. edsloan@uic.edu
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MeSH Terms
Descriptor/Qualifier:
Acidosis, Lactic / blood,  epidemiology*,  etiology
Adult
Aspirin / adverse effects,  analogs & derivatives*,  chemistry,  therapeutic use
Emergency Medical Services
Emergency Treatment
Europe / epidemiology
Fluid Therapy / adverse effects,  methods
Hemoglobins / adverse effects,  chemistry,  therapeutic use*
Humans
Lactic Acid / blood
Multicenter Studies as Topic
Regression Analysis
Resuscitation / adverse effects,  methods*
Shock, Hemorrhagic / complications,  drug therapy*,  mortality
Shock, Traumatic / complications,  drug therapy*,  mortality
Survival Analysis
Treatment Outcome
United States / epidemiology
Water-Electrolyte Imbalance / epidemiology*,  etiology
Wounds and Injuries / complications
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/diaspirin-cross-linked hemoglobin; 50-21-5/Lactic Acid; 50-78-2/Aspirin
Investigator
Investigator/Affiliation:
Edward P Sloan / ; Max D Koenigsberg / ; William C Dalsey / ; Mark Kaplan / ; Pamela Taggart / ; Thomas A Santora / ; Jeffrey Runge / ; Lucinda A Edwards / ; Michael A Gibbs / ; Glen Tinkoff / ; Patty McGraw / ; Robert O'Conner / ; Rita K Cydulka / ; William F Fallon / ; Brian Plaisier / ; J Stanley Smith / ; Robert N Cooney / ; Margaret Shand / ; Mark D Cipolle / ; Michael D Pasquale / ; Wendy J Robb / ; Gage Ochsner / ; Frank E Davis / ; Joseph Rondina / ; George H Rodman / ; Charles Miralgia / ; Maureen Misinski / ; Patrick H Brunett / ; James H Bryan / ; Colleen McDevitt / ; David Provost / ; Mary Jane Colpi / ; Russel Stoltzfus / ; Raymond P Bynoe / ; Jay D Hamm / ; N John Stewart / ; Dave Amsden / ; Christine Walukewicz / ; Thomas Wachtel / ; Ray Coniglio / ; Lee Hemminger / ; Mary Nan S Mallory / ; Eddy Carillo / ; Richard L Miller / ; Ashlee Miller / ; David R Gens / ; Laura A Joseph / ; Mehrunissa H Owens / ; Andrew B Peitzman / ; Marilyn J Borst / ; Randy J Woods / ; John A Morris / ; Judy Jenkins / ; J Duncan Harviel / ; Marion Jordan / ; Dennis Wang / ; Lisa Beylo / ; Kristin Y Brandenburg / ; James A Dougherty / ; Lynn J White / ; Farid Muakkassa / ; Fred Harchelroad / ; Kris Potts / ; M Andrew Levitt / ; Ed Portoni / ; Eva Hirvela / ; Mathew J Wall / ; Kenneth L Mattox / ; Alex Mendez / ; Michele Holevar / ; Gary Merlotti / ; Sue Berry / ; Edward P Sloan / ; John Barrett / ; Kim Nagy / ; Steve Stapleton / ; Juan A March / ; Susan Copeland / ; Paul Catrou / ; George A Perdrizet / ; Donna Rescrol / ; Lenworth Jacobs / ; Terry Kowalenko / ; Barry Dereczyk / ; Emanuel P Rivers / ; Pascal Nyachowe / ; Judy Mikhil / ; Richard Fantus / ; Sharon Ward / ; Mark Langdorf / ; Ronald Simon / ; Dennis Martinez / ; Kate Botner / ; Patricia Ann O'Neill / ; Richard Sinert / ; Karen Sue Eisenberg / ; Joan H Howanitz / ; Dennis C Gore / ; Sherry Lockhart / ; Heather Chibelski / ; Les Zun / ; Annette Kinsela / ; Dennis Uehara / ; Jeffrey Maves / ; George Z Hevesy / ; Michael Badellino / ; Robert Buckman / ; Steven Go / ; Ginger Morse / ; Berna Sue Casper / ; Norman McSwain / ; Ruth Ann Wanstrath / ; Fred A Luchette / ; Richard D Branson / ; Kenneth Davis / ; John J Fildes / ; Connie A Clemmons-Brown / ; Cindy Roehr / ; Harvey Meislin / ; Cheryle Gomez / ; George C Velmahos / ; Raymond Tatevossian / ; Roger J Lewis / ; Donald Berry / ; Norman Fost / ; Ronald Krome / ; Geraldine Washington / ; Marian Fisher / ; Robin Bechhofer / ; Tom Cook / ; Melissa Schultz / ; Robert Przybelski / ; John Blue / ; Cynthia Goldberg / ; Kathleen Stern / ; Jaime Houghton / ; Maulik Nanavaty / ; Timothy Estep / ; Michael Saunders / ; Tom Schmitz / ; Alted / ; Todorov / ; Vanderpas / ; Fox / ; Decroix / ; Schtickzelle / ; Beaucourt / ; Bouletreau / ; Collombel / ; Samii / ; Mazi?re / ; Ossart / ; Dabadie / ; Bertrand / ; Coriat / ; Guerrini / ; Chauvin / ; Bladier / ; Delacoux / ; Marty / ; Bemer / ; Desmonts / ; Stoessel / ; Freysz / ; Duvaldestin / ; Goossens / ; Payen / ; Rouvier / ; Cathala / ; Adenet / ; Rousseaux / ; Ducasse / ; Pasteyer / ; Feiss / ; Reinhart / ; Dick / ; Gotzen / ; Weinand / ; Ellinger / ; Tappe / ; Regel / ; Schmucker / ; R?se / ; Sokolowski / ; Motsch / ; Unertl / ; Katz / ; Benad / ; Schuff-Werner / ; Bergner / ; Sch?ttler / ; Hergert / ; Lestin / ; J Bion / ; P Ferdinande / ; A Grootendorst / ; R Little / ; C Robertson / ; D Spahn / ; D Spiegelhalter / ; A Webb / ; S Holmstrom / ; D Gerard / ; T Reppucci / ; A Morrison / ; J Blue / ; C Goldberg / ; R Przybelski / ; K Stern / ; J Houghton / ; R Sperelakis / ; K Wallace / ; J Petty / ; D Balma / ; B Bottoms / ; P Carli /

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