Infusion of stroma-free cross-linked hemoglobin during acute gram-negative bacteremia.
Twelve dogs were divided into two groups of six each, and were infused with bis-3,5-dibromosalicyl fumarate stroma-free hemoglobin (DBBF-Hb) or albumin. Their responses to an intravenous bolus of Escherichia coli were followed for 4 hr. Bacterial clearance from the blood stream was studied using standard colony counting methodology as well as blood counts, blood chemistries, and clotting factor analysis. There was a significant difference in mean arterial pressure (MAP) over time between DBBF-Hb-treated dogs and those treated with albumin (P < 0.02). While the DBBF-treated dogs had a higher MAP during the 10 min of bacteremia, after 1 hr, there were no longer any appreciable differences between septic dogs treated with DBBF-Hb vs. albumin. Consumption of clotting and natural anticoagulant factors was observed to be similar in both groups, as were endotoxin levels. Blood urea nitrogen (BUN) increased slightly in both groups, while white blood cell counts and clotting factor levels fell in both groups in a similar fashion. There was a more pronounced fall (P < 0.04) in platelet counts in the animals treated with DBBF-Hb. In the dogs treated with DBBF-Hb, there was also a late rise in pCO2 (P < 0.01), a more pronounced fall in pO2, and greater acidosis, which suggested that ventilation perfusion abnormalities may have been exacerbated by DBBF-Hb treatment. Since the exacerbation of respiratory abnormalities was not related to diminished bacterial or endotoxin clearance, the possibility is raised that DBBF-Hb interferes with compensatory respiratory changes during sepsis.
Crowley
J P
JP
Department of Medicine, Brown University, Providence, RI 02903.
Metzger
J
J
Gray
A
A
Pivacek
L E
LE
Cassidy
G
G
Valeri
C R
CR
D000208:Acute Disease; D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016470:Bacteremia / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004285:Dogs; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006454:Hemoglobins / Q000627:therapeutic use*; D008297:Male; D009569:Nitric Oxide / Q000502:physiology; D012709:Serum Albumin / Q000627:therapeutic use
D003432:Cross-Linking Reagents; D006454:Hemoglobins; D012709:Serum Albumin; C021630:bis(3,5-dibromosalicyl)fumarate; D002245:Carbon Dioxide; D009569:Nitric Oxide; D001241:Aspirin