Small-volume resuscitation with the hemoglobin substitute HBOC-201: effect on brain tissue oxygenation.
OBJECTIVE
To investigate the effects of small-volume resuscitation with a hemoglobin based oxygen carrier on brain tissue oxygen tension (PbrO2) in hemorrhaged swine.


METHODS
Clark-type electrodes were inserted into the brain tissue of 6 swine to measure PbrO2 directly. Swine were hemorrhaged to a MAP of 40 mm Hg for 20 minutes. Resuscitation was performed with a bolus infusion of HBOC-201 (6 cc/kg; Biopure Corp.) and high-flow oxygen (100%). Swine were observed for an additional 2 hours.


RESULTS
PbrO2 prior to hemorrhage was 48.7 +/- 4.7 mm Hg with 100% inspired oxygen. PbrO2 rapidly declined to 7.6 +/- 5.3 mm Hg in response to hemorrhage. Small-volume resuscitation with HBOC-201 and high-flow oxygen resulted in a significant increase (p < 0.001) in PbrO2 to 44.6 +/- 8.1 mm Hg. MAP was also significantly increased to 84% of baseline. These elevations were sustained during the observation period.


CONCLUSIONS
Resuscitation with HBOC-201 can restore and sustain cerebral oxygenation and MAP. These results suggest that a small-volume bolus of HBOC-201 may provide adequate oxygen and pressure support during the initial management of hemorrhage.
Manley
Geoffrey T
GT
School of Medicine, University of California San Francisco, San Francisco Injury Center, Department of Neurological Surgery, USA.
Hemphill
J Claude
JC
Morabito
Diane
D
Erickson
Vanessa
V
Holcroft
John J
JJ
Derugin
Nakita
N
Knudson
M Margaret
MM
D000818:Animals; D001802:Blood Substitutes / Q000008:administration & dosage* / Q000494:pharmacology; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D006454:Hemoglobins; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D012151:Resuscitation; D013552:Swine
D001802:Blood Substitutes; D006454:Hemoglobins; C096798:HBOC 201; D010100:Oxygen