Comparison of transfusion with DCLHb or pRBCs for treatment of intraoperative anemia in sheep.
Isoflurane-anesthetized sheep were transfused with packed red blood cells (pRBCs) or diaspirin cross-linked hemoglobin (DCLHb) for treatment of intraoperative hemorrhage. A rapid 15-min hemorrhage with lactated Ringer (LR) infusion maintained filling pressure at baseline and reduced blood hemoglobin (Hb) to ~5 g/dl. Sheep received 2 g/kg Hb, DCLHb (n = 6), or pRBCs (n = 7); control group received LR alone (n = 6). After 2 h, anesthesia was discontinued; sheep were monitored in the animal intensive care unit for 48 h. DCLHb expanded blood volume more, but increased total blood Hb less, than pRBCs. Lower Hb and increased methemoglobin resulted in lower arterial oxygen content compared with the pRBCs. DCLHb caused pulmonary hypertension (from 13 to 30 mmHg) and elevated filling pressure (from 6 to 15 mmHg). Cardiac outputs (CO) were similar for all groups during anesthesia; however, during recovery CO increased only in the LR and packed pRBCs groups. DCLHb may limit the reflex ability to increase CO after volume expansion. Hemodynamic effects of DCLHb may be exaggerated when infused after large-volume LR.
Vane
Luiz A
LA
Resuscitation Research Laboratories, Departments of Anesthesiology and Physiology, University of Texas Medical Branch, Galveston, Texas 77555-080, USA.
Funston
J Sean
JS
Kirschner
Robert
R
Harper
Don
D
Deyo
Donald J
DJ
Traber
Daniel L
DL
Traber
Lillian L
LL
Kramer
George C
GC
D000740:Anemia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D000758:Anesthesia; D000818:Animals; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001802:Blood Substitutes / Q000627:therapeutic use*; D001810:Blood Volume; D017707:Erythrocyte Transfusion; D006321:Heart / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism / Q000627:therapeutic use*; D006470:Hemorrhage / Q000150:complications / Q000503:physiopathology; D007432:Intraoperative Period; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D011652:Pulmonary Circulation / Q000187:drug effects / Q000502:physiology; D012756:Sheep
D001802:Blood Substitutes; D006454:Hemoglobins; C083478:diaspirin-cross-linked hemoglobin; D001241:Aspirin