Diaspirin cross-linked hemoglobin improves oxygen extraction capabilities in endotoxic shock.
We studied the effects of diaspirin cross-linked hemoglobin (DCLHb), a cell-free hemoglobin derived from human erythrocytes, on blood flow distribution and tissue oxygen extraction capabilities in endotoxic shock. Eighteen pentobarbital sodium-anesthetized, mechanically ventilated dogs received 2 mg/kg of E. coli endotoxin, followed by saline resuscitation to restore cardiac filling pressures to baseline levels. The animals were randomly divided into three groups: six served as control, six received DCLHb at a dose of 500 mg/kg (group 1) and six DCLHb at a dose of 1,000 mg/kg (group 2). Cardiac tamponade was then induced by saline injection in the pericardial sac to progressively reduce cardiac index and thereby allow study of tissue oxygen extraction capabilities. DCLHb had a dose-dependent vasopressor effect but did not significantly alter cardiac index or regional blood flow. During cardiac tamponade, critical oxygen delivery was 12.8 +/- 0.7 ml. kg(-1). min(-1) in the control group, but 8.6 +/- 0.9 and 8.2 +/- 0.7 ml. kg(-1). min(-1) in groups 1 and 2, respectively (both P < 0.05 vs. control group). The critical oxygen extraction ratio was 39.1 +/- 3.1% in the control group but 58.7 +/- 12.8% and 60.2 +/- 9.0% in groups 1 and 2, respectively. We conclude that DCLHb can improve whole body oxygen extraction capabilities during endotoxic shock in dogs.
Creteur
J
J
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, B-1070 Brussels, Belgium.
Zhang
H
H
De Backer
D
D
Sun
Q
Q
Vincent
J L
JL
D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D001802:Blood Substitutes / Q000494:pharmacology*; D002302:Cardiac Output / Q000187:drug effects; D002305:Cardiac Tamponade; D004285:Dogs; D004731:Endotoxins; D004926:Escherichia coli; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006454:Hemoglobins / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects*; D012039:Regional Blood Flow / Q000187:drug effects; D012772:Shock, Septic / Q000097:blood / Q000503:physiopathology* / Q000628:therapy
D001802:Blood Substitutes; D004731:Endotoxins; D006454:Hemoglobins; C083478:diaspirin-cross-linked hemoglobin; D001241:Aspirin; D010100:Oxygen