Resuscitation of pulmonary contusion: effects of a red cell substitute.
OBJECTIVE
To determine the impact of a vasoactive red cell substitute, diaspirin cross-linked hemoglobin, on respiratory derangements after traumatic lung injury.


METHODS
Randomized, controlled animal experiment.


METHODS
Large-animal laboratory.


METHODS
Mechanically ventilated, anesthetized young Yorkshire male swine (15 to 20 kg).


METHODS
Pigs (n = 6/group) received two pneumatic blasts to the right thoracic cage at baseline, were hemorrhaged 30 mL/kg from t = 0 to 20 mins, resuscitated with 0.9% saline (group 1, 90 mL/ kg) or diaspirin cross-linked hemoglobin (group 2, 15 mL/kg) from t = 20 to 40 mins, and then observed to t = 240 mins.


RESULTS
Serial pulmonary and systemic hemodynamic measurements, total thoracic compliance assessment, spiral three-dimensional computed tomography scan, and lung weights (n = 3/group) were used to assess lesion size and lung water. Mean arterial pressure was restored in both animal groups. Mean pulmonary arterial pressure was significantly higher after resuscitation in animals receiving the red cell substitute. Oxygenation worsened mildly in both groups. Compliance diminished in both groups but was significantly worse at the end of the experiment in animals infused with diaspirin cross-linked hemoglobin. Right lung weights and right thoracic computed tomography scan volume were higher with diaspirin cross-linked hemoglobin than with saline.


CONCLUSIONS
After pulmonary contusion, resuscitation with diaspirin cross-linked hemoglobin led to pulmonary hypertension, greater pulmonary contusion lesion size, and stiffer lungs in this porcine model.
Cohn
S M
SM
Department of Surgery, Yale School of Medicine, New Haven, CT, 06510, USA.
Zieg
P M
PM
Rosenfield
A T
AT
Fisher
B T
BT
D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives*; D001802:Blood Substitutes / Q000627:therapeutic use*; D003288:Contusions / Q000000981:diagnostic imaging / Q000628:therapy*; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D006439:Hemodynamics / Q000187:drug effects; D006454:Hemoglobins / Q000627:therapeutic use*; D055370:Lung Injury; D008297:Male; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods*; D013552:Swine; D014057:Tomography, X-Ray Computed
D001802:Blood Substitutes; D006454:Hemoglobins; C030830:succinyldisalicylic acid; D001241:Aspirin