| Effects of the resuscitation fluid and the hemoglobin based oxygen carrier (HBOC) excipient on the toxicity of the HBOC: Ringer's D,L-lactate, Ringer's L-lactate, and Ringer's ketone solutions. | |
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MedLine Citation:
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PMID: 17090432 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hemoglobin based oxygen carriers (HBOC) are resuspended in "excipients" consisting of Ringer's D,L-lactate containing antioxidants to prevent methemoglobin formation during storage. Investigators have reported cardiac arrhythmias following infusion of Ringer's D,L-lactate solution. Studies have shown that D-lactate stimulates human granulocytes to generate oxygen free radicals and L-lactate inhibits glycolysis. Patients receiving HBOC in Ringer's D,L-lactate excipient are also resuscitated or hemodiluted with Ringer's lactate solution. Oxygen-free radicals generated by Ringer's D,L-lactate and HBOC may oxidize nitric oxide in endothelial cells, causing the vasoconstrictor effects reported following HBOC infusion, and activate NF-kappab and the apoptotic cascade. The combination of Ringer's D,L-lactate and HBOC in Ringer's D,L-lactate excipient may be responsible for the severe adverse events observed in clinical studies of HBOC.Veech has recommended replacing the 27 mM of lactate in Ringer's with 27 mM D-betahydroxybutyrate (BHB). BHB reduces the generation of oxygen free radicals by mitochondria and human granulocytes. |
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Authors:
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C Robert Valeri; Gina Ragno; Richard L Veech |
Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review |
Journal Detail:
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Title: Artificial cells, blood substitutes, and immobilization biotechnology Volume: 34 ISSN: 1073-1199 ISO Abbreviation: Artif Cells Blood Substit Immobil Biotechnol Publication Date: 2006 |
Date Detail:
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Created Date: 2006-11-08 Completed Date: 2006-12-21 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 9431307 Medline TA: Artif Cells Blood Substit Immobil Biotechnol Country: United States |
Other Details:
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Languages: eng Pagination: 601-6 Citation Subset: IM |
Affiliation:
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Naval Blood Research Laboratory, 195 Bournehurst Drive, Plymouth, MA 02360, USA. navblood@nbrl.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Substitutes / adverse effects* Excipients / adverse effects* Fluid Therapy Humans Isotonic Solutions / adverse effects*, chemistry, pharmacology Rats |
| Chemical | |
Reg. No./Substance:
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0/Blood Substitutes; 0/Excipients; 0/Isotonic Solutions; 8022-63-7/Ringer's lactate; 8026-10-6/Ringer's solution |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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