title: Hemoglobin-based oxygen carrier (HBOC-201) and escalating doses of recombinant factor VIIa (rFVIIa) as a novel pre-hospital resuscitation fluid in a swine model of severe uncontrolled hemorrhage.
abstract: Exsanguinating hemorrhage and unavailability of blood are major problems in pre-hospital trauma care. We investigated if combining rFVIIa with HBOC-201 reduces blood loss and improves physiologic parameters compared to HBOC alone. Swine underwent liver injury and were resuscitated with HBOC-201 alone or HBOC+90, 180 or 360 μg/kg rFVIIa before hospital arrival at 240 min; animals survived to 72 hours. Blood loss was reduced; MAP, CI, transcutaneous oxygen saturation, and 72-hour survival improved in the 90 and 180 μg/kg rFVIIa groups. Lactate was cleared faster in the HBOC+rFVIIa 90 μg/kg group. Verification in a large, well-powered study is indicated.
authors.affiliation: Operational and Undersea Medicine Directorate, NeuroTrauma Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA. anke.scultetus@med.navy.mil
authors.forename: Anke
authors.initials: A
authors.lastname: Scultetus
authors.forename: Francoise
authors.initials: F
authors.lastname: Arnaud
authors.forename: Lewis
authors.initials: L
authors.lastname: Kaplan
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
authors.forename: Nora
authors.initials: N
authors.lastname: Philbin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rice
authors.forename: Richard
authors.initials: R
authors.lastname: McCarron
authors.forename: Daniel
authors.initials: D
authors.lastname: Freilich
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D001802:Blood Substitutes / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D015942:Factor VIIa / Q000008:administration & dosage*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006454:Hemoglobins / Q000008:administration & dosage*; D006470:Hemorrhage / Q000401:mortality / Q000628:therapy*; D019344:Lactic Acid / Q000032:analysis / Q000097:blood; D008099:Liver / Q000293:injuries; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D012151:Resuscitation; D015996:Survival Rate; D013552:Swine
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; D011994:Recombinant Proteins; C096798:HBOC 201; D019344:Lactic Acid; C103587:recombinant FVIIa; D015942:Factor VIIa