title: Bovine hemoglobin increases skeletal muscle oxygenation during 95% artificial arterial stenosis.
abstract: BACKGROUND
  This study investigates the effect of a stroma-free ultrapurified bovine hemoglobin solution (HBOC) on skeletal muscle tissue oxygenation in comparison with hetastarch during nearly complete arterial stenosis.
  
  
  METHODS
  Fourteen foxhounds were intravenously anesthetized and mechanically ventilated with 30% oxygen in air. Catheters were inserted into the right femoral artery and vein for measurements of hemodynamic parameters and blood gas sampling. Arterial blood flow of the left popliteal artery was measured by means of an electromagnetic flow probe. Skeletal muscle tissue oxygen tension (tpO2) was measured in the left gastrocnemius muscle by using a stepwise driven polarographic needle probe creating histograms from 200 single tpO2 measurements. After isovolemic hemodilution with Ringer's lactate solution to a hematocrit of 25%, a 95% artificial stenosis of the popliteal artery was established. The animals then randomly received two applications of either 50 ml HBOC (molecular weight, 32,000 to 500,000; hemoglobin, 13 +/- 1 gm/dl-1) or 200 ml 6% hetastarch 200,000/0.5. Variables were measured at baseline, after hemodilution, 30 minutes after stenosis, and 15 minutes after two applications of the respective compound.
  
  
  RESULTS
  Demographic data, muscle temperature, and arterial blood gases did not differ between groups. With the exception of higher mean arterial and mean pulmonary artery pressures in HBOC-treated animals, hemodynamics did not differ between groups. In both groups oxygen delivery and oxygen consumption of the muscle decreased in parallel to the decreasing blood flow during arterial stenosis. In contrast, oxygen extraction ratio increased after infusion of HBOC and was higher after the second application when compared with hetastarch-treated animals (p < 0.05). During stenosis tpO2 was decreased in both groups when compared with baseline (p < 0.001). Mean tpO2 remained at decreased levels after administration of hetastarch but increased to nearly baseline values after HBOC treatment (p < 0.001).
  
  
  CONCLUSIONS
  The data suggest that increased oxygen extraction in the HBOC group is associated with improved skeletal muscle tissue oxygenation during severe arterial stenosis.
authors.affiliation: Department of Anesthesiology, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: E P
authors.initials: EP
authors.lastname: Horn
authors.forename: T
authors.initials: T
authors.lastname: Standl
authors.forename: S
authors.initials: S
authors.lastname: Wilhelm
authors.forename: E E
authors.initials: EE
authors.lastname: Jacobs
authors.forename: U
authors.initials: U
authors.lastname: Freitag
authors.forename: M
authors.initials: M
authors.lastname: Freitag
authors.forename: J
authors.initials: J
authors.lastname: Schulte am Esch
mesh_terms: D000818:Animals; D001157:Arterial Occlusive Diseases / Q000503:physiopathology*; D004285:Dogs; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000494:pharmacology*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D019344:Lactic Acid / Q000097:blood; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D011150:Popliteal Artery
chemical_list: D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; D019344:Lactic Acid; D010100:Oxygen