Oxygen Transport Dynamics After Resuscitation With a Conjugated Hemoglobin Solution

摘要: Hypothesis: Pyridoxalated hemoglobin polyoxyethylene conjugate (PHP), a hemoglobin-based oxygen carrier, is effective in restoring hemodynamic balance and delivery after moderate hemorrhage but may be less off-loading at the tissue level. Design: Before-after trial. Setting: Animal research laboratory of an academic institution. Participants: Ten female Yorkshire swine. Interventions: Anesthetized swine underwent 25% controlled followed by resuscitation with crystalloid plus either shed blood or PHP. Hemodynamicparameters,includingheartrate,meanarterialpressure, mean pulmonary arterial pressure, cardiac index were continuously monitored. Arterial mixed venous samples collected baseline, hemorrhage,afterresuscitation,andevery15minutesfor 90minutesafterresuscitation.Oxygendeliveryandconsumption,oxygenextractionratios,andpercentageofcontribution to consumption determined whole blood, red cells, plasma using compartmentalized approach. Main Outcome Measures: Intergroup intragroupcomparisonswereperformedforhemodynamicparameters transport dynamics. Results: Heart rate returned closer baseline levels thePHPgroup(P.05)andmeanpulmonaryarterialpressure was transiently elevated infusion PHP (P=.028), otherwise no significant differences observed. The extraction ratio from cells group more than doubled, whereas remained constant. percentage contribution plasma,includingPHP,tooxygendeliveryexceeded20% (P .05), relative did not markedly change baseline. Conclusions:Pyridoxalated least as hemorrhage. There disproportionately low consumption, which suggests that act sink anemia.