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. 2011 Jun;39(6):1461-6.
doi: 10.1097/CCM.0b013e3182120cdb.

Vasoactive hemoglobin solution improves survival in hemodilution followed by hemorrhagic shock

Beatriz Y Salazar Vázquez  1 , C Makena Hightower, Judith Martini, Catalina Messmer, Barbara Frienesenecker, Pedro Corbels, Amy G Tsai, Marcos Intaglietta
Affiliations

Vasoactive hemoglobin solution improves survival in hemodilution followed by hemorrhagic shock

Beatriz Y Salazar Vázquez et al. Crit Care Med. 2011 Jun.

Abstract

Objective: To compare survival after exchange transfusion followed by hemorrhage using: 1) the vasoactive, oxygen-carrying, bovine hemoglobin-based blood substitute Oxyglobin (Biopure, 12.9 g hemoglobin/dL); and 2) the hydroxyethyl starch plasma expander Hextend (high molecular weight and low degree of substitution, 6%).

Design: Comparison between treatments.

Setting: Laboratory.

Subjects: Awake hamster chamber window model.

Interventions: Fifty percent blood volume exchange transfusion followed by a 60% hemorrhage over 1 hr, followed by 1 hr of observation. Measurement of blood gases, mean arterial blood pressure, functional capillary density, arteriolar and venular diameter, and Po2 tension distribution.

Measurements and main results: Survival with Oxyglobin was 100% and only 50% for the Hextend group. Vasoconstriction was evident in the microcirculation. Mean arterial pressure was higher in the Oxyglobin group. Functional capillary density was significantly reduced, although to a lesser extent by Oxyglobin. There was no difference in microvascular Po2 distribution after 1 hr of shock between groups.

Conclusions: Higher mean arterial pressure during the initial stages of hemorrhage could be due to vasoconstriction in the Oxyglobin group as compared to the Hextend group. It is concluded that the pressor effect due to a vasoactive oxygen carrier may be beneficial in maintaining perfusion in conditions of severe hemodilution followed by hypovolemia.

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Conflict of interest statement

The remaining authors have not disclosed any potential conflicts of interest.

Figures

Figure 1
Figure 1
Timeline of procedures and measurements.
Figure 2
Figure 2
Survival following exchange transfusion and hemorrhage.
Figure 3
Figure 3
Functional capillary density relative to baseline. HD: hemodilution; H0 – H60 hemorrhage phase; S30 – S60 shock phase, starting at H60. Numbers are time in minutes. p < .05 relative to BL (*), HD (†), H30 (‡); analysis between treatments at the same time point: p < .05 (§).
Figure 4
Figure 4
Microvascular diameters relative to baseline. Arteriole (A) diameters: 35 - 50 μm and venules (B) 40 - 70 μm at baseline. HD: hemodilution; H30 – H60 hemorrhage phase; S30 – S60 shock phase, starting at H60. Analysis within the same treatment group: p < .05 relative to BL (*), HD (†), H30 (‡). Analysis between treatments at the same time point: p < .05 (§).
Figure 5
Figure 5
Distribution of pO2 at the end of the shock phase of blood vessels and tissue treated with Oxyglobin and Hextend. The data are pooled since there was no statistical difference between groups.
See this image and copyright information in PMC

Comment in

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