title: Diaspirin cross-linked hemoglobin is efficacious in gut resuscitation as measured by a GI tract optode.
abstract: The objective of this study was to compare the efficacy of diaspirin cross-linked hemoglobin (DCLHb) with that of standard resuscitative fluids in restoring intestinal mucosal oxygenation and villous architecture after hemorrhage. Male rats were bled to a base deficit of 5 +/- 2 nmol/l under propofol anesthesia and monitored for 90 minutes postresuscitation with DCLHb, blood, lactated Ringer's solution, albumin, or nothing (DNR) for mucosal oxygen tension (Pmo2) and physiologic and laboratory parameters. Small intestinal histologic specimens were obtained and scored independently by two investigators blinded to therapy on a scale of 0 (normal) to 4 (worst). All treatments restored Pmo2; only DCLHb did so without exceeding baseline values. For untreated rats (DNR), Pmo2 was not restored. Normal mucosal architecture was maintained only in DCLHb-treated rats. As Pmo2 increased, mucosal score improved. In a rat model of controlled hemorrhage, Pmo2 changes measured by an optode correlated with gut histological abnormalities. By these criteria, DCLHb is superior to crystalloid, colloid, and blood in gut resuscitation.
authors.affiliation: Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Frankel
authors.forename: H B
authors.initials: HB
authors.lastname: Nguyen
authors.forename: T
authors.initials: T
authors.lastname: Shea-Donohue
authors.forename: L A
authors.initials: LA
authors.lastname: Aiton
authors.forename: J
authors.initials: J
authors.lastname: Ratigan
authors.forename: D S
authors.initials: DS
authors.lastname: Malcolm
mesh_terms: D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001794:Blood Pressure; D005440:Fluid Therapy; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000628:therapy*; D006454:Hemoglobins / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology*; D008297:Male; D010100:Oxygen / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D012151:Resuscitation / Q000379:methods*
chemical_list: D006454:Hemoglobins; C083478:diaspirin-cross-linked hemoglobin; D001241:Aspirin; D010100:Oxygen