Acute effects of massive transfusion of a bovine hemoglobin blood substitute in a canine model of hemorrhagic shock.
The capability of stroma-free hemoglobin solutions to act as a plasma expander with oxygen and carbon dioxide transport properties has encouraged the idea of their possible use in settings of massive blood loss. Using a canine hemorrhagic shock model (systolic arterial pressure < or = 50 torr for 60 min), we evaluated the efficacy of an ultra-pure stroma-free bovine hemoglobin solution (PBHg) as a resuscitation fluid in hypovolemic and acidotic animals, using homologous blood (PRBC) and 10% human serum albumin (HSA) as control solutions. Following volume replacement, dogs were studied for 2 h under anesthesia and for 4 h subsequently while awake. Resuscitation with PBHg (30 +/- 3 ml/kg) was able to restore stable hemodynamics and correct acidosis to an extent comparable to that in animals treated with PRBC. Additionally, oxygen transport was maintained at a higher level than that in dogs treated with HSA. Administration of PBHg in this shock model revealed no significant cardiopulmonary toxicity or adverse effects. These short-term results suggest that PBHg may be useful for effective resuscitation after major blood loss.
Harringer
W
W
Department of Surgery, Massachusetts General Hospital, Boston 02114.
Hodakowski
G T
GT
Svizzero
T
T
Jacobs
E E
EE
Vlahakes
G J
GJ
D000818:Animals; D016913:Blood Component Transfusion; D001802:Blood Substitutes; D001803:Blood Transfusion / Q000379:methods*; D001810:Blood Volume / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D004285:Dogs; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006454:Hemoglobins / Q000494:pharmacology*; D008297:Male; D010100:Oxygen / Q000097:blood; D012151:Resuscitation; D012709:Serum Albumin / Q000494:pharmacology; D012771:Shock, Hemorrhagic / Q000503:physiopathology*
D001802:Blood Substitutes; D006454:Hemoglobins; D012709:Serum Albumin; C037158:polyhemoglobin; D002245:Carbon Dioxide; D010100:Oxygen