title: Small-volume resuscitation with the hemoglobin substitute HBOC-201: effect on brain tissue oxygenation.
abstract: 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.
authors.affiliation: School of Medicine, University of California San Francisco, San Francisco Injury Center, Department of Neurological Surgery, USA.
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Manley
authors.forename: J Claude
authors.initials: JC
authors.lastname: Hemphill
authors.forename: Diane
authors.initials: D
authors.lastname: Morabito
authors.forename: Vanessa
authors.initials: V
authors.lastname: Erickson
authors.forename: John J
authors.initials: JJ
authors.lastname: Holcroft
authors.forename: Nakita
authors.initials: N
authors.lastname: Derugin
authors.forename: M Margaret
authors.initials: MM
authors.lastname: Knudson
mesh_terms: 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
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; C096798:HBOC 201; D010100:Oxygen