HBOC-201 improves survival in a swine model of hemorrhagic shock and liver injury.
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.
Katz
Laurence M
LM
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
Manning
James E
JE
McCurdy
Shane
S
Pearce
L Bruce
LB
Gawryl
Maria S
MS
Wang
Yuanfan
Y
Brown
Chad
C
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
D001802:Blood Substitutes; D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; C096798:HBOC 201