Document Detail


Diaspirin cross-linked hemoglobin resuscitation improves cerebral perfusion after head injury and shock.
MedLine Citation:
PMID:  8913204     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Shock associated with traumatic brain injury (TBI) doubles the mortality of TBI alone by inducing a secondary ischemic injury. Rapid correction of cerebral perfusion pressure (CPP) is thought to be essential to improving outcome. Diaspirin cross-linked hemoglobin (DCLHb) has been shown to improve cerebral blood flow, increase mean arterial pressure (MAP), and reduce lesion size in models of occlusive cerebral ischemia but has not been evaluated in a model of TBI combined with hemorrhagic shock. METHODS: We studied the effects of DCLHb resuscitation in a porcine model of cryogenic TBI and hemorrhagic shock (MAP = 50 mmHg). After combined insults, animals were randomized to receive a bolus of 4 mliters/kg of either lactated Ringer's solution (n = 5) or DCLHb (n = 6). Lactated Ringer's solution was then infused in both groups to maintain MAP at baseline. Shed blood was returned 1 hour after the initiation of resuscitation (R1). Animals were studied for 24 hours. RESULTS: DCLHb infusion resulted in a significantly greater MAP at R1 and R24 (95 +/- 4 vs. 82 +/- 2 and 99 +/- 3 vs. 85 +/- 3 mm Hg, respectively) and a significantly greater CPP at R1 and R24 (83 +/- 10 vs. 68 +/- 5 and 89 +/- 6 vs. 71 +/- 11 mm Hg, respectively). Intracranial pressure was lower in the DCLHb group, but this difference was not significant. There was no significant difference between the groups in cerebral oxygen delivery. DCLHb animals required less fluid to maintain MAP (12,094 +/- 552 vs. 15,542 +/- 1094 mliters, p < 0.05). CONCLUSION: These data suggest that DCLHb is beneficial in the early resuscitation of head injury and shock and that further investigation is warranted. Key Words: Diaspirin cross-linked hemoglobin, Head injury, Shock, Cerebral perfusion pressure.
Authors:
J E Chappell; W J McBride; S R Shackford
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of trauma     Volume:  41     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1996-12-11     Completed Date:  1996-12-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  781-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Vermont, Burlington 05401, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aspirin / analogs & derivatives*,  pharmacology,  therapeutic use
Blood Pressure / drug effects
Brain Injuries / complications,  physiopathology*,  therapy*
Cerebrovascular Circulation / drug effects*
Fluid Therapy
Hemodynamics / drug effects
Hemoglobins / pharmacology*,  therapeutic use
Intracranial Pressure / drug effects
Models, Biological
Oxygen / blood
Resuscitation / methods*
Shock / etiology,  physiopathology*,  therapy*
Swine
Swine, Miniature
Vascular Resistance / drug effects
Grant Support
ID/Acronym/Agency:
P20-NS30324-03/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/diaspirin-cross-linked hemoglobin; 50-78-2/Aspirin; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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