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Resuscitation from hemorrhagic shock comparing standard hemoglobin-based oxygen carrier (HBOC)-201 versus 7.5% hypertonic HBOC-201.
J Trauma. 2007 Nov; 63(5):1113-9.JT

Abstract

BACKGROUND

Hemoglobin-based oxygen carrier (HBOC) resuscitation has been associated with increased systemic and pulmonary vascular resistances (SVR, PVR), which may result in reduced blood flow and severe pulmonary hypertension. The physiologic and immunologic properties of 7.5% hypertonic saline solution (HTS), such as reduction of SVR and PVR, as well as inhibition of neutrophil and endothelial activation may be beneficial in reducing some of these undesirable effects of HBOCs. The aim of this study was to evaluate the hemodynamic effects of the HBOC and HBOC-201 suspended in 7.5% hypertonic saline solution (HT-HBOC) when compared with standard HBOC resuscitation.

METHODS

Thirty-two domestic crossbred pigs (50-60 kg) were hemorrhaged to a mean arterial pressure (MAP) of 35 mm Hg +/- 5 mm Hg for 45 minutes and resuscitated to a baseline mean arterial pressure using the following groups: (1) sham, no hemorrhage; (2) shed blood + lactated Ringer's solution; (3) standard HBOC-201; (4) hypertonic saline 7.5%; (5) hypertonic 7.5% HBOC-201. After resuscitation, observation was continued for 4 hours. Hemodynamic variables, oxygen consumption, and arterial blood gases were monitored continuously. Data were analyzed using analysis of variance.

RESULTS

SVR (p = 0.001), PVR (p = 0.001), and MPAP (p = 0.01) were significantly reduced in the HT-HBOC group compared with the standard HBOC group.

CONCLUSION

In this model of hemorrhagic shock, hypertonic HBOC-201- resuscitated pigs had significantly reduced SVR and PVR, as well as mean pulmonary artery pressure (MPAP) and increased cardiac output. HT-HBOC may be beneficial in reducing the undesirable effects of standard HBOC-201. The mechanisms of these beneficial effects need to be investigated.

Authors+Show Affiliations

Department of Surgery, Division of Burn/Trauma/Critical Care, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9160, USA. fernando.rivera@UTSW.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17993959

Citation

Rivera-Chavez, Fernando A., et al. "Resuscitation From Hemorrhagic Shock Comparing Standard Hemoglobin-based Oxygen Carrier (HBOC)-201 Versus 7.5% Hypertonic HBOC-201." The Journal of Trauma, vol. 63, no. 5, 2007, pp. 1113-9.
Rivera-Chavez FA, Huerta S, Brown R, et al. Resuscitation from hemorrhagic shock comparing standard hemoglobin-based oxygen carrier (HBOC)-201 versus 7.5% hypertonic HBOC-201. J Trauma. 2007;63(5):1113-9.
Rivera-Chavez, F. A., Huerta, S., Brown, R., York, G. B., & Minei, J. P. (2007). Resuscitation from hemorrhagic shock comparing standard hemoglobin-based oxygen carrier (HBOC)-201 versus 7.5% hypertonic HBOC-201. The Journal of Trauma, 63(5), 1113-9.
Rivera-Chavez FA, et al. Resuscitation From Hemorrhagic Shock Comparing Standard Hemoglobin-based Oxygen Carrier (HBOC)-201 Versus 7.5% Hypertonic HBOC-201. J Trauma. 2007;63(5):1113-9. PubMed PMID: 17993959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resuscitation from hemorrhagic shock comparing standard hemoglobin-based oxygen carrier (HBOC)-201 versus 7.5% hypertonic HBOC-201. AU - Rivera-Chavez,Fernando A, AU - Huerta,Sergio, AU - Brown,Ronnie, AU - York,Gregory B, AU - Minei,Joseph P, PY - 2007/11/13/pubmed PY - 2008/1/8/medline PY - 2007/11/13/entrez SP - 1113 EP - 9 JF - The Journal of trauma JO - J Trauma VL - 63 IS - 5 N2 - BACKGROUND: Hemoglobin-based oxygen carrier (HBOC) resuscitation has been associated with increased systemic and pulmonary vascular resistances (SVR, PVR), which may result in reduced blood flow and severe pulmonary hypertension. The physiologic and immunologic properties of 7.5% hypertonic saline solution (HTS), such as reduction of SVR and PVR, as well as inhibition of neutrophil and endothelial activation may be beneficial in reducing some of these undesirable effects of HBOCs. The aim of this study was to evaluate the hemodynamic effects of the HBOC and HBOC-201 suspended in 7.5% hypertonic saline solution (HT-HBOC) when compared with standard HBOC resuscitation. METHODS: Thirty-two domestic crossbred pigs (50-60 kg) were hemorrhaged to a mean arterial pressure (MAP) of 35 mm Hg +/- 5 mm Hg for 45 minutes and resuscitated to a baseline mean arterial pressure using the following groups: (1) sham, no hemorrhage; (2) shed blood + lactated Ringer's solution; (3) standard HBOC-201; (4) hypertonic saline 7.5%; (5) hypertonic 7.5% HBOC-201. After resuscitation, observation was continued for 4 hours. Hemodynamic variables, oxygen consumption, and arterial blood gases were monitored continuously. Data were analyzed using analysis of variance. RESULTS: SVR (p = 0.001), PVR (p = 0.001), and MPAP (p = 0.01) were significantly reduced in the HT-HBOC group compared with the standard HBOC group. CONCLUSION: In this model of hemorrhagic shock, hypertonic HBOC-201- resuscitated pigs had significantly reduced SVR and PVR, as well as mean pulmonary artery pressure (MPAP) and increased cardiac output. HT-HBOC may be beneficial in reducing the undesirable effects of standard HBOC-201. The mechanisms of these beneficial effects need to be investigated. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/17993959/Resuscitation_from_hemorrhagic_shock_comparing_standard_hemoglobin_based_oxygen_carrier__HBOC__201_versus_7_5_hypertonic_HBOC_201_ L2 - https://doi.org/10.1097/TA.0b013e3181561157 DB - PRIME DP - Unbound Medicine ER -