Document Detail


Oxygent as a top load to colloid and hyperoxia is more effective in resuscitation from hemorrhagic shock than colloid and hyperoxia alone.
MedLine Citation:
PMID:  16135964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Perfluorocarbon (PFC) emulsions are intravascular oxygen therapeutics that temporarily enhance tissue oxygenation in dilutional anemia. However, PFC emulsions are not resuscitation fluids because PFCs only work optimally in the presence of high O2 partial pressure (hyperoxia); moreover, because they have no oncotic potential, dosing limitations prevent their use to permanently replace large hemorrhage volumes. Our objective was to clarify whether in the presence of hyperoxia a conventional colloid therapy supplemented by PFC is more efficacious than colloid alone. To answer this question, 22 anesthetized, ventilated dogs were hemorrhaged to a mean arterial pressure of 45 mmHg and were kept at this level until a metabolic O2 debt of 120 mL kg(-1) body weight had evolved. Hyperoxia was established and dogs were randomly allocated to receive colloid (6% HES, Hydroxy Ethyl Starch shed blood volume) or colloid together with Oxygent (perflubron emulsion, 60%, w/v; Alliance Pharmaceutical Corp., San Diego, CA; single dose, 4.5 mL kg(-1); i.e., 2.7 g PFC kg body weight) in a blinded fashion. Hemodynamic and O2 transport parameters, intestinal mucosal blood flow (microspheres), and O2 partial pressure (MDO-Electrode; Eschweiler, Kiel, Germany) were measured at baseline, in shock, and during 3 h post-therapy. In the presence of hyperoxia, Oxygent improved the amount of physically dissolved O2 in plasma and increased the contribution of physically dissolved O2 to global O2 delivery (P < 0.05) and thus whole body O2 consumption when compared with colloid alone (P < 0.05). As a result, Oxygent reduced intestinal mucosal hypoxia and global O2 debt within the first hour post-therapy (P < 0.05). We conclude that under hyperoxic conditions, fluid resuscitation supplemented by Oxygent was more efficacious than colloid and hyperoxia alone. PFC temporarily enhanced intestinal mucosal tissue oxygenation during resuscitation.
Authors:
Gregor I Kemming; Franz G Meisner; Christoph J Wojtczyk; Kristian B Packert; Thomas Minor; Manfred Thiel; Jochen Tillmanns; Jens Meier; Daniel Bottino; Peter E Keipert; Simon Faithfull; Oliver P Habler
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  24     ISSN:  1073-2322     ISO Abbreviation:  Shock     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-01     Completed Date:  2005-11-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-54     Citation Subset:  IM    
Affiliation:
Institute for Surgical Research, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, 81377, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anoxia / pathology*
Body Weight
Colloids / chemistry*
Contrast Media / pharmacology
Dogs
Fluorocarbons / chemistry,  pharmacology*
Hematocrit
Hemodynamics
Hemorrhage
Hetastarch / chemistry
Hypoxanthine / chemistry
Intestinal Mucosa / pathology
Oxygen / metabolism
Oxygen Consumption
Perfusion
Shock, Hemorrhagic / pathology,  therapy*,  veterinary
Spleen / cytology,  pathology
Time Factors
Xanthine / chemistry
Chemical
Reg. No./Substance:
0/Colloids; 0/Contrast Media; 0/Fluorocarbons; 423-55-2/perflubron; 68-94-0/Hypoxanthine; 69-89-6/Xanthine; 7782-44-7/Oxygen; 9005-27-0/Hetastarch

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


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