Hemorrhagic shock resuscitation with an artificial oxygen carrier, hemoglobin vesicle, maintains intestinal perfusion and suppresses the increase in plasma tumor necrosis factor-alpha.
It is known that damage to the intestinal mucosa followed by systemic inflammatory response is one of the leading causes of shock related morbidity and mortality. In this study, we examined the ability of an artificial oxygen carrier hemoglobin vesicle (HbV) to sustain systemic and intestinal perfusion during hemorrhagic shock. In rabbits, hemorrhagic shock (40% of the estimated blood volume) was resuscitated with 5% albumin (alb group), HbV suspended in 5% albumin (HbValb group), or washed red blood cells suspended in 5% albumin (RBCalb group). Plasma tumor necrosis factor (TNF)-alpha level was measured in rats under the same experimental protocol. No significant intergroup differences were seen in systemic hemodynamics. In contrast, parameters of intestinal perfusion significantly deteriorated in the alb group but were equally well sustained in the HbValb and RBCalb groups. Also, a significant increase in plasma TNF-alpha level was seen in the alb group but not in the RBCalb or HbValb groups. These results indicate the proficient oxygen transporting capability of HbV and its potential efficacy in shock resuscitation.
Yoshizu
Akira
A
Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
Izumi
Yotaro
Y
Park
Sungick
S
Sakai
Hiromi
H
Takeoka
Shinji
S
Horinouchi
Hirohisa
H
Ikeda
Eiji
E
Tsuchida
Eishun
E
Kobayashi
Koichi
K
D000818:Animals; D001802:Blood Substitutes / Q000627:therapeutic use*; D006454:Hemoglobins; D007413:Intestinal Mucosa / Q000098:blood supply*; D008297:Male; D011817:Rabbits; D051381:Rats; D012771:Shock, Hemorrhagic / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism*
D001802:Blood Substitutes; D006454:Hemoglobins; D014409:Tumor Necrosis Factor-alpha