Plasma volume expansion with solutions of hemoglobin, albumin and Ringer's lactate in sheep

Stefanie Fischer, Michael Burnet, Daniel L. Traber, Donald Prough, George Kramer

Research output: Contribution to journalArticle

Abstract

Introduction: Hemoglobin based blood substitutes have been well studied with respect to oxygen carrying and vascular effects, but little is known about their volume expansion properties. Methods: In the present study we measured plasma volume expansion (Evans blue and hematocrit changes) and hemodynamic responses in conscious hemorrhaged (mean arterial pressure = 50 mmHg for 2 hrs) and normovolemic splenectomized sheep, after a 30-min infusion of either 20ml/kg 10% diaspirin cross-linked hemoglobin (DCLHb), 20ml/kg 8% human albumin (Alb) or 60ml/kg of a solution of Ringer's lactate (RL). Results: All regimens expanded blood volume, and increased blood pressure and cardiac output after hemorrhage. However, only 15±3% of the infused volume of RL were evident as intravascular expansion 10-min post-infusion, compared to 67±16% and 139±139% for Alb and DCLHb, respectively. DCLHb infusions were associated with higher blood pressures and lower cardiac outputs compared to RL and Alb, but the increased O 2 content of blood with DCLHb resulted in similar systemic delivery of oxygen. These differences in hemodynamics and vascular volume continued for 2-hrs, after 24-hrs vascular volume and all hemodynamics were similar in all three groups. The better volume expansion with DCLHb may be due to greater mobilization of endogenous interstitial protein or reduced transcapillary loss as total intravascular endogenous plasma protein increased after infusion of DCLHb, while after infusions of Alb and RL there was an apparent loss of endogenous intravascular protein. Vasoconstriction by DCLHb could lower blood-to-tissue transport of fluid and protein. Conclusions: In addition to oxygen carrying and vasoactivity, DCLHb is associated with volume expansion properties out of proportion to its colloid osmotic pressure.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume27
Issue number1 SUPPL.
StatePublished - 1999

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Plasma Volume
Albumins
Sheep
Hemoglobins
Blood Vessels
Hemodynamics
Oxygen
Cardiac Output
Blood Substitutes
Evans Blue
diaspirin-cross-linked hemoglobin
Ringer's lactate
Osmotic Pressure
Colloids
Vasoconstriction
Blood Volume
Hematocrit
Blood Proteins
Carrier Proteins
Arterial Pressure

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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Plasma volume expansion with solutions of hemoglobin, albumin and Ringer's lactate in sheep. / Fischer, Stefanie; Burnet, Michael; Traber, Daniel L.; Prough, Donald; Kramer, George.

In: Critical Care Medicine, Vol. 27, No. 1 SUPPL., 1999.

Research output: Contribution to journalArticle

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N2 - Introduction: Hemoglobin based blood substitutes have been well studied with respect to oxygen carrying and vascular effects, but little is known about their volume expansion properties. Methods: In the present study we measured plasma volume expansion (Evans blue and hematocrit changes) and hemodynamic responses in conscious hemorrhaged (mean arterial pressure = 50 mmHg for 2 hrs) and normovolemic splenectomized sheep, after a 30-min infusion of either 20ml/kg 10% diaspirin cross-linked hemoglobin (DCLHb), 20ml/kg 8% human albumin (Alb) or 60ml/kg of a solution of Ringer's lactate (RL). Results: All regimens expanded blood volume, and increased blood pressure and cardiac output after hemorrhage. However, only 15±3% of the infused volume of RL were evident as intravascular expansion 10-min post-infusion, compared to 67±16% and 139±139% for Alb and DCLHb, respectively. DCLHb infusions were associated with higher blood pressures and lower cardiac outputs compared to RL and Alb, but the increased O 2 content of blood with DCLHb resulted in similar systemic delivery of oxygen. These differences in hemodynamics and vascular volume continued for 2-hrs, after 24-hrs vascular volume and all hemodynamics were similar in all three groups. The better volume expansion with DCLHb may be due to greater mobilization of endogenous interstitial protein or reduced transcapillary loss as total intravascular endogenous plasma protein increased after infusion of DCLHb, while after infusions of Alb and RL there was an apparent loss of endogenous intravascular protein. Vasoconstriction by DCLHb could lower blood-to-tissue transport of fluid and protein. Conclusions: In addition to oxygen carrying and vasoactivity, DCLHb is associated with volume expansion properties out of proportion to its colloid osmotic pressure.

AB - Introduction: Hemoglobin based blood substitutes have been well studied with respect to oxygen carrying and vascular effects, but little is known about their volume expansion properties. Methods: In the present study we measured plasma volume expansion (Evans blue and hematocrit changes) and hemodynamic responses in conscious hemorrhaged (mean arterial pressure = 50 mmHg for 2 hrs) and normovolemic splenectomized sheep, after a 30-min infusion of either 20ml/kg 10% diaspirin cross-linked hemoglobin (DCLHb), 20ml/kg 8% human albumin (Alb) or 60ml/kg of a solution of Ringer's lactate (RL). Results: All regimens expanded blood volume, and increased blood pressure and cardiac output after hemorrhage. However, only 15±3% of the infused volume of RL were evident as intravascular expansion 10-min post-infusion, compared to 67±16% and 139±139% for Alb and DCLHb, respectively. DCLHb infusions were associated with higher blood pressures and lower cardiac outputs compared to RL and Alb, but the increased O 2 content of blood with DCLHb resulted in similar systemic delivery of oxygen. These differences in hemodynamics and vascular volume continued for 2-hrs, after 24-hrs vascular volume and all hemodynamics were similar in all three groups. The better volume expansion with DCLHb may be due to greater mobilization of endogenous interstitial protein or reduced transcapillary loss as total intravascular endogenous plasma protein increased after infusion of DCLHb, while after infusions of Alb and RL there was an apparent loss of endogenous intravascular protein. Vasoconstriction by DCLHb could lower blood-to-tissue transport of fluid and protein. Conclusions: In addition to oxygen carrying and vasoactivity, DCLHb is associated with volume expansion properties out of proportion to its colloid osmotic pressure.

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