Document Detail


Regional blood flow after serial normovolemic exchange transfusion with HBOC-201 (Hemopure) in anesthetized swine.
MedLine Citation:
PMID:  19590308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study determined individual organ blood flows and global hemodynamic, oxygen delivery and consumption parameters after normovolemic exchange transfusions with the hemoglobin based oxygen carrier (HBOC)-201 in a lightly anesthetized swine model. METHODS: The exchange transfusions were performed as a stepped reduction in blood volume to attain volume exchanges of 10%, 30%, and 50% with a 1:1 replacement with HBOC-201 (n = 8) or oncotically matched 5.9% human serum albumin (HSA, n = 8). Four additional animals served as time controls. RESULTS: There was no change in the regional blood flows in 8 of 9 organs (brain, heart, kidney, liver, pancreas, gall bladder, small intestines, large intestines, and skeletal muscle) after HBOC-201 compared with controls; only skeletal muscle blood flow decreased. In contrast, with HSA, blood flow increased 150% to 200% of baseline in all organs except muscle where blood flow was unchanged. HBOC-201 effectively restored oxygen delivery after these exchanges. The mean arterial pressure increases in the HBOC-201 group were within 15% to 20% of baseline during the initial 10% exchange and similar to controls during subsequent exchanges. Although peak pulmonary arterial pressure increases in the HBOC-201 group were 10 mm Hg to 15 mm Hg above baseline, cardiac index was unchanged. There were no differences in global oxygen consumption, consistent with unchanged regional blood flow and suggests intact physiologic coupling of oxygen delivery and consumption that was unimpaired by local vasoconstriction. This is in contrast to significant changes of increased cardiac index, decreased arterial pressure, decreased oxygen content, and increased oxygen extraction ratio to maintain normal oxygen consumption in the HSA group. CONCLUSION: Although the use of HBOC-201 caused alterations in systemic (minimal) and pulmonary (modest) pressures, these changes had no consequence on regional organ blood flow.
Authors:
Paul D Mongan; Paula F Moon-Massat; Virginia Rentko; Shanda Mihok; Anthony Dragovich; Pushpa Sharma
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of trauma     Volume:  67     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-10     Completed Date:  2009-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  51-60     Citation Subset:  AIM; IM    
Affiliation:
Hemorrhagic Shock Laboratory, Department of Anesthesiology, The Uniformed Services University, Bethesda, Maryland 20854, USA.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General*
Animals
Blood Pressure / physiology
Blood Substitutes / administration & dosage*
Disease Models, Animal
Exchange Transfusion, Whole Blood / methods*
Hemoglobins / administration & dosage*
Oxygen Consumption / drug effects,  physiology
Regional Blood Flow / drug effects,  physiology*
Shock, Hemorrhagic / metabolism,  physiopathology,  therapy*
Swine
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Substitutes; 0/HBOC 201; 0/Hemoglobins

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


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