title: HBOC-201 improves survival in a swine model of hemorrhagic shock and liver injury.
abstract: BACKGROUND
  Blunt abdominal trauma that leads to hemorrhagic shock and cardiac arrest is almost always fatal in the prehospital setting. The current study investigated whether a hemoglobin-based oxygen carrier (HBOC-201) could maintain organ viability during an exsanguinating liver injury and allow for prolonged survival. This hypothesis was tested in a large animal model that simulated blunt abdominal trauma with major organ injury.
  
  
  METHODS
  Swine underwent a liver crush, laceration and 50 ml/kg initial blood loss. The liver bled at 3 ml/kg per min during the resuscitation phase. No fluid (NF=6), hetastarch (HES=8), or HBOC-201 (HBOC=8) was given during the resuscitation phase. Swine alive 60 min after the initial injury underwent liver repair and 96 h observation.
  
  
  RESULTS
  All HBOC swine survived 60 min versus none of the NF or HES swine (P<0.05). All HBOC swine survived 24 h and 7/8 survived 96 h with good functional recovery.
  
  
  CONCLUSIONS
  HBOC resuscitation during liver bleeding in a swine model of hemorrhagic shock and liver injury allowed for 96 h survival. No fluid or HES in the same model was fatal.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of North Carolina, Neurosciences Hospital Ground Floor, 101 Manning Drive, CB 7594, Chapel Hill, NC 27599, USA. lkatz@med.unc.edu
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Katz
authors.forename: James E
authors.initials: JE
authors.lastname: Manning
authors.forename: Shane
authors.initials: S
authors.lastname: McCurdy
authors.forename: L Bruce
authors.initials: LB
authors.lastname: Pearce
authors.forename: Maria S
authors.initials: MS
authors.lastname: Gawryl
authors.forename: Yuanfan
authors.initials: Y
authors.lastname: Wang
authors.forename: Chad
authors.initials: C
authors.lastname: Brown
mesh_terms: D000818:Animals; D001794:Blood Pressure; D001802:Blood Substitutes / Q000008:administration & dosage / Q000627:therapeutic use*; D001810:Blood Volume; D004195:Disease Models, Animal; D006454:Hemoglobins / Q000627:therapeutic use*; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D008099:Liver / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D012151:Resuscitation / Q000379:methods; D012771:Shock, Hemorrhagic / Q000628:therapy*; D016019:Survival Analysis; D013552:Swine
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; C096798:HBOC 201