Extracorporeal membrane oxygenation in piglets using a polymerized bovine hemoglobin-based oxygen-carrying solution (HBOC-201).
OBJECTIVE
The purpose of this study was to determine if the polymerized bovine hemoglobin-based oxygen-carrying solution HBOC-201 is an acceptable substitute for blood in a healthy porcine, extracorporeal membrane oxygenation (ECMO) model.


METHODS
Ten piglets (15 to 25 kg) were placed on venoarterial ECMO. Four animals received blood-primed ECMO, and 6 animals received HBOC-201-primed ECMO. Hemodynamic variables, urine output, blood gas analyses, complete blood counts, and lactate levels were followed for 6 hours. Data were analyzed using a nonparametric sign test and repeated measures analysis of variance (ANOVA).


RESULTS
All animals survived the 6-hour ECMO procedure. Heart rate, mean arterial pressure, urine output, and serum lactate levels were not significantly different between groups. Postpriming volume was 176 +/- 156 mL in the blood group. None of the animals in the HBOC-201 group required additional volume to maintain target flow during ECMO (P <.05). Arterial pH, pO2, and oxygen content between groups were not significantly different. Hematocrit for the HBOC-201 group was significantly (P <.05) lower than the blood group.


CONCLUSIONS
HBOC-201-primed ECMO in a healthy porcine model showed similar hemodynamics and equivalent oxygen carrying capacity to blood-primed ECMO. Postpriming volume requirement was decreased significantly in the HBOC group. ECMO using HBOC-201 instead of blood appears promising and warrants further investigation.
York
Gregory B
GB
Department of General Surgery, Wilford Hall Medical Center, Lackland AFB, TX, USA.
DiGeronimo
Robert J
RJ
Wilson
Bernard J
BJ
Cofer
Barry R
BR
Breuer
Christopher K
CK
Josephs
John D
JD
Smith
David L
DL
Sorrells
Donald L
DL
D000818:Animals; D001784:Blood Gas Analysis; D001802:Blood Substitutes / Q000008:administration & dosage* / Q000378:metabolism; D002417:Cattle; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006400:Hematocrit; D006439:Hemodynamics; D006454:Hemoglobins / Q000008:administration & dosage* / Q000378:metabolism; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000097:blood; D023421:Models, Animal; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010313:Partial Pressure; D011108:Polymers / Q000008:administration & dosage* / Q000378:metabolism; D013552:Swine; D014556:Urine / Q000502:physiology
D001802:Blood Substitutes; D006454:Hemoglobins; D011108:Polymers; C080663:polymerized bovine hemoglobin; C096798:HBOC 201; D019344:Lactic Acid; D010100:Oxygen