Abstract
Objective: We tested the hypothesis that the pharmacologic properties of a small volume of αα-cross-linked hemoglobin (ααHb) could effectively resuscitate pigs subjected to hemorrhage. Methods: Fourteen pigs hemorrhaged to a mean arterial pressure (MAP) of 40 mm Hg for 60 minutes were treated with a 4-mL/kg 2-minute infusion of 10 g/dL ααHb or 7 g/dL human serum albumin, an oncotically matched control solution. Results: The removal of blood (17 ± 1.5 mL/kg) caused the typical physiologic responses to hemorrhagic hypovolemia. Infusion of ααHb restored mean arterial pressure and coronary perfusion pressure, but cardiac output and mixed venous O2 saturation did not improve significantly. Pulmonary arterial pressure and pulmonary vascular resistance increased markedly and were higher than baseline levels after ααHb. Infusion of human serum albumin produced only minor hemodynamic changes. Brain blood flow did improve to baseline values after ααHb, but was the only tissue to do so. In the human serum albumin group, superior mesenteric artery blood flow recovered to baseline values, whereas brain blood flow did not. Blood flows to other tissues were similar in both groups. Conclusion: Small-volume infusion of ααHb restored mean arterial pressure and brain blood flow, but pulmonary hypertension and low peripheral perfusion may offset benefits for trauma patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 847-856 |
| Number of pages | 10 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 42 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1997 |
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Keywords
- Blood substitutes
- Hemoglobin
- Hemorrhage
- Microspheres
- Nitric oxide
- Regional blood flow
- Shock
- Vasoconstriction
ASJC Scopus subject areas
- Surgery
Cite this
Pulmonary hypertension and systemic vasoconstriction may offset the benefits of acellular hemoglobin blood substitutes. / Poli De Figueiredo, Luiz F.; Mathru, Mali; Solanki, Daneshvari; Macdonald, Victor W.; Hess, John; Kramer, George.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 42, No. 5, 05.1997, p. 847-856.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pulmonary hypertension and systemic vasoconstriction may offset the benefits of acellular hemoglobin blood substitutes
AU - Poli De Figueiredo, Luiz F.
AU - Mathru, Mali
AU - Solanki, Daneshvari
AU - Macdonald, Victor W.
AU - Hess, John
AU - Kramer, George
PY - 1997/5
Y1 - 1997/5
N2 - Objective: We tested the hypothesis that the pharmacologic properties of a small volume of αα-cross-linked hemoglobin (ααHb) could effectively resuscitate pigs subjected to hemorrhage. Methods: Fourteen pigs hemorrhaged to a mean arterial pressure (MAP) of 40 mm Hg for 60 minutes were treated with a 4-mL/kg 2-minute infusion of 10 g/dL ααHb or 7 g/dL human serum albumin, an oncotically matched control solution. Results: The removal of blood (17 ± 1.5 mL/kg) caused the typical physiologic responses to hemorrhagic hypovolemia. Infusion of ααHb restored mean arterial pressure and coronary perfusion pressure, but cardiac output and mixed venous O2 saturation did not improve significantly. Pulmonary arterial pressure and pulmonary vascular resistance increased markedly and were higher than baseline levels after ααHb. Infusion of human serum albumin produced only minor hemodynamic changes. Brain blood flow did improve to baseline values after ααHb, but was the only tissue to do so. In the human serum albumin group, superior mesenteric artery blood flow recovered to baseline values, whereas brain blood flow did not. Blood flows to other tissues were similar in both groups. Conclusion: Small-volume infusion of ααHb restored mean arterial pressure and brain blood flow, but pulmonary hypertension and low peripheral perfusion may offset benefits for trauma patients.
AB - Objective: We tested the hypothesis that the pharmacologic properties of a small volume of αα-cross-linked hemoglobin (ααHb) could effectively resuscitate pigs subjected to hemorrhage. Methods: Fourteen pigs hemorrhaged to a mean arterial pressure (MAP) of 40 mm Hg for 60 minutes were treated with a 4-mL/kg 2-minute infusion of 10 g/dL ααHb or 7 g/dL human serum albumin, an oncotically matched control solution. Results: The removal of blood (17 ± 1.5 mL/kg) caused the typical physiologic responses to hemorrhagic hypovolemia. Infusion of ααHb restored mean arterial pressure and coronary perfusion pressure, but cardiac output and mixed venous O2 saturation did not improve significantly. Pulmonary arterial pressure and pulmonary vascular resistance increased markedly and were higher than baseline levels after ααHb. Infusion of human serum albumin produced only minor hemodynamic changes. Brain blood flow did improve to baseline values after ααHb, but was the only tissue to do so. In the human serum albumin group, superior mesenteric artery blood flow recovered to baseline values, whereas brain blood flow did not. Blood flows to other tissues were similar in both groups. Conclusion: Small-volume infusion of ααHb restored mean arterial pressure and brain blood flow, but pulmonary hypertension and low peripheral perfusion may offset benefits for trauma patients.
KW - Blood substitutes
KW - Hemoglobin
KW - Hemorrhage
KW - Microspheres
KW - Nitric oxide
KW - Regional blood flow
KW - Shock
KW - Vasoconstriction
UR - http://www.scopus.com/inward/record.url?scp=0001517449&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0001517449&partnerID=8YFLogxK
U2 - 10.1097/00005373-199705000-00015
DO - 10.1097/00005373-199705000-00015
M3 - Article
C2 - 9191666
AN - SCOPUS:0001517449
VL - 42
SP - 847
EP - 856
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -