title: Systemic hemodynamics and renal function in hemorrhaged dogs resuscitated with cross-linked hemoglobin.
abstract: Cross-linked hemoglobin (XL-Hb) infused into dogs increases mean arterial pressure (MAP) but decreases blood flow to the renal (RBF), mesenteric (MBF), and iliac (IBF) circulations. These actions differ markedly from dextran infusion (which increases RBF, MBF, and IBF without altering MAP) and may be due to scavenging of nitric oxide by XL-Hb. However, because the hormonal milieu regulating regional circulation is altered during hemorrhage (when XL-Hb may be used), we studied whether systemic hemodynamics, RBF, MBF, IBF, and renal excretory function in hemorrhaged dogs was altered when resuscitated with XL-Hb compared with dextran (n = 6 each). Hemorrhage decreased MAP by 25% due to a 75% decline in cardiac output. RBF, MBF, and IBF all fell by 33, 64, and 72%, respectively (P<0.05 each). There was also a fall in glomerular filtration rate (GFR), urinary flow, and sodium excretion (P<0.05 each). After resuscitation, MAP, cardiac output, RBF, MBF, IBF, and GFR all recovered to basal values with either XL-Hb or dextran. Urinary flow and sodium excretion increased to above basal levels with dextran (both by 3.5-fold; P<0.05) or XL-Hb (by 7.5- and 10-fold, respectively; P<0.05). We conclude that resuscitation with XL-Hb after hemorrhage not only increases MAP, but also restores RBF, MBF, IBF, GFR, and urinary sodium and volume excretion analogously to dextran. The results contrast with those in normal dogs and suggest that nitric oxide inhibition does not impair hemodynamic and renal function recovery during hemorrhage.
authors.affiliation: Department of Physiology and Biophysics and Divisions of Hypertension and Nephrology, Mayo School of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Stulak
authors.forename: L A
authors.initials: LA
authors.lastname: Juncos
authors.forename: J A
authors.initials: JA
authors.lastname: Haas
authors.forename: J C
authors.initials: JC
authors.lastname: Romero
mesh_terms: D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002319:Cardiovascular System / Q000187:drug effects; D003911:Dextrans / Q000627:therapeutic use; D004231:Diuresis / Q000187:drug effects; D004285:Dogs; D006439:Hemodynamics / Q000187:drug effects*; D006454:Hemoglobins / Q000627:therapeutic use*; D006470:Hemorrhage / Q000503:physiopathology* / Q000628:therapy*; D007085:Ilium / Q000098:blood supply; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology*; D009318:Natriuresis / Q000187:drug effects; D010952:Plasma Substitutes / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D012079:Renal Circulation / Q000187:drug effects; D012151:Resuscitation; D013152:Splanchnic Circulation / Q000187:drug effects
chemical_list: D003911:Dextrans; D006454:Hemoglobins; D010952:Plasma Substitutes; C053936:hemoglobin XL99alpha; D001241:Aspirin