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Bovine polymerized hemoglobin versus Hextend resuscitation in a swine model of severe controlled hemorrhagic shock with delay to definitive care.
Shock. 2006 Sep; 26(3):302-10.S

Abstract

To compare the efficacy of low-volume resuscitation with bovine polymerized hemoglobin (HBOC-201) versus hetastarch (HEX) in an intermediate severity combat-relevant hemorrhagic shock swine model with a simulated delay to hospital care. Twenty-four anesthetized pigs were hemorrhaged 55% estimated blood volume in conjunction with a 5-min rectus abdominus crush. At 20 min, pigs were resuscitated with 10 mL/kg of HBOC-201 or HEX or nothing (NON); resuscitated pigs received additional infusions (5 mL/kg) at 30, 60, 120, or 180 min if hypotension or tachycardia persisted. Pigs were monitored for a 4-h "prehospital" period. At 4-h, hospital arrival was simulated: surgical sites were repaired, blood, or saline provided, and pigs were recovered from anesthesia. Pigs were monitored for 72 h and then killed for histological evaluation. One hundred percent (8/8) of HBOC-201-, 75% (6/8) of HEX-, and 25% (2/8) of NON-resuscitated pigs survived to 72 h (P = 0.007 overall, HBOC vs. HEX P > 0.05). Mean arterial pressure and mean pulmonary arterial pressure were highest in the HBOC-201 group (P < 0.001), and HR was lowest (P < 0.001). HBOC-201- and HEX-resuscitated pigs had comparable cardiac index and prehospital fluid requirements. HBOC-201 pigs had higher transcutaneous tissue oxygen tension, P < 0.001) and lower urine output (P < 0.001). At simulated hospital arrival, no HBOC-201 pigs required additional fluids or blood transfusion. In contrast, 100% of HEX pigs required blood transfusions (P < 0.01). In this swine model of controlled hemorrhage with low-volume resuscitation and delayed definitive care, HBOC-201 pigs had improved hemodynamics, transcutaneous tissue oxygen tension, and transfusion avoidance compared with HEX.

Authors+Show Affiliations

Naval Medical Research Center, Silver Spring, MD 20910, USA. ricej@nmrc.navy.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16912657

Citation

Rice, Jennifer, et al. "Bovine Polymerized Hemoglobin Versus Hextend Resuscitation in a Swine Model of Severe Controlled Hemorrhagic Shock With Delay to Definitive Care." Shock (Augusta, Ga.), vol. 26, no. 3, 2006, pp. 302-10.
Rice J, Philbin N, McGwin G, et al. Bovine polymerized hemoglobin versus Hextend resuscitation in a swine model of severe controlled hemorrhagic shock with delay to definitive care. Shock. 2006;26(3):302-10.
Rice, J., Philbin, N., McGwin, G., Arnaud, F., Johnson, T., Flournoy, W. S., Pearce, L. B., McCarron, R., Kaplan, L., Handrigan, M., & Freilich, D. (2006). Bovine polymerized hemoglobin versus Hextend resuscitation in a swine model of severe controlled hemorrhagic shock with delay to definitive care. Shock (Augusta, Ga.), 26(3), 302-10.
Rice J, et al. Bovine Polymerized Hemoglobin Versus Hextend Resuscitation in a Swine Model of Severe Controlled Hemorrhagic Shock With Delay to Definitive Care. Shock. 2006;26(3):302-10. PubMed PMID: 16912657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bovine polymerized hemoglobin versus Hextend resuscitation in a swine model of severe controlled hemorrhagic shock with delay to definitive care. AU - Rice,Jennifer, AU - Philbin,Nora, AU - McGwin,Gerald, AU - Arnaud,Françoise, AU - Johnson,Todd, AU - Flournoy,W Shannon, AU - Pearce,L Bruce, AU - McCarron,Richard, AU - Kaplan,Lew, AU - Handrigan,Michael, AU - Freilich,Daniel, PY - 2006/8/17/pubmed PY - 2006/10/13/medline PY - 2006/8/17/entrez SP - 302 EP - 10 JF - Shock (Augusta, Ga.) JO - Shock VL - 26 IS - 3 N2 - To compare the efficacy of low-volume resuscitation with bovine polymerized hemoglobin (HBOC-201) versus hetastarch (HEX) in an intermediate severity combat-relevant hemorrhagic shock swine model with a simulated delay to hospital care. Twenty-four anesthetized pigs were hemorrhaged 55% estimated blood volume in conjunction with a 5-min rectus abdominus crush. At 20 min, pigs were resuscitated with 10 mL/kg of HBOC-201 or HEX or nothing (NON); resuscitated pigs received additional infusions (5 mL/kg) at 30, 60, 120, or 180 min if hypotension or tachycardia persisted. Pigs were monitored for a 4-h "prehospital" period. At 4-h, hospital arrival was simulated: surgical sites were repaired, blood, or saline provided, and pigs were recovered from anesthesia. Pigs were monitored for 72 h and then killed for histological evaluation. One hundred percent (8/8) of HBOC-201-, 75% (6/8) of HEX-, and 25% (2/8) of NON-resuscitated pigs survived to 72 h (P = 0.007 overall, HBOC vs. HEX P > 0.05). Mean arterial pressure and mean pulmonary arterial pressure were highest in the HBOC-201 group (P < 0.001), and HR was lowest (P < 0.001). HBOC-201- and HEX-resuscitated pigs had comparable cardiac index and prehospital fluid requirements. HBOC-201 pigs had higher transcutaneous tissue oxygen tension, P < 0.001) and lower urine output (P < 0.001). At simulated hospital arrival, no HBOC-201 pigs required additional fluids or blood transfusion. In contrast, 100% of HEX pigs required blood transfusions (P < 0.01). In this swine model of controlled hemorrhage with low-volume resuscitation and delayed definitive care, HBOC-201 pigs had improved hemodynamics, transcutaneous tissue oxygen tension, and transfusion avoidance compared with HEX. SN - 1073-2322 UR - https://www.unboundmedicine.com/medline/citation/16912657/Bovine_polymerized_hemoglobin_versus_Hextend_resuscitation_in_a_swine_model_of_severe_controlled_hemorrhagic_shock_with_delay_to_definitive_care_ L2 - https://doi.org/10.1097/01.shk.0000226338.48033.c2 DB - PRIME DP - Unbound Medicine ER -