title: Immune effects of decreasing low-molecular weight hemoglobin components of hemoglobin-based oxygen carriers (HBOC) in a swine model of severe controlled hemorrhagic shock.
abstract: Hemoglobin-based oxygen carriers (HBOCs) show potential as safe, efficacious, pre-hospital resuscitation fluids. The major criticism of HBOC-201 is its vasoactive property, attributed partially to low-molecular weight (low-MW) tetrameric/dimeric (TD) hemoglobin (Hb) in HBOC solution. Here we sought to determine whether resuscitation with decreasing concentrations of low-MW Hb component of HBOC affects immune responses in hemorrhagic swine. 28 anesthetized swine underwent a soft muscle crush and controlled hemorrhage of 55% blood volume, followed by resuscitation with HBOC containing 31%, 2%, or 0.4% low-MW Hb in four 10 ml/kg infusions at 20, 30, 45 and 60 minutes before hospital arrival at 75 minutes. IL-10, cell activation and adhesion markers and CD4:CD8 ratio remained unchanged in all 3 groups compared to baseline. Leukocyte apoptosis was equally elevated across all groups. Purification from 31% to 0.4% low-MW Hb in HBOC solution did not alter immune effects in a swine model of severe controlled hemorrhagic shock.
authors.affiliation: Naval Medical Research Center, Combat Casualty Department, Silver Spring, MD 20910-7500, USA.
authors.forename: C
authors.initials: C
authors.lastname: VanderMolen
authors.forename: N
authors.initials: N
authors.lastname: Malkevich
authors.forename: N
authors.initials: N
authors.lastname: Philbin
authors.forename: J
authors.initials: J
authors.lastname: Rice
authors.forename: S
authors.initials: S
authors.lastname: Collier
authors.forename: C
authors.initials: C
authors.lastname: Hall
authors.forename: S
authors.initials: S
authors.lastname: Ahlers
authors.forename: R
authors.initials: R
authors.lastname: McCarron
authors.forename: D
authors.initials: D
authors.lastname: Freilich
authors.forename: G
authors.initials: G
authors.lastname: McGwin
authors.forename: L Bruce
authors.initials: LB
authors.lastname: Pearce
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000276:immunology; D001802:Blood Substitutes / Q000009:adverse effects*; D004195:Disease Models, Animal; D005440:Fluid Therapy; D006454:Hemoglobins / Q000009:adverse effects / Q000276:immunology*; D007113:Immunity, Innate / Q000276:immunology*; D011897:Random Allocation; D012771:Shock, Hemorrhagic / Q000628:therapy*; D034421:Sus scrofa
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; C096798:HBOC 201