VOLUME RESUSCITATION FROM HEMORRHAGIC SHOCK WITH ALBUMIN AND HEXA PEGYLATED HUMAN SERUM ALBUMIN

摘要

The effect of restoring intravascular volume with polyethylene glycol (PEG) conjugated to human serum albumin (PEG-Alb) on systemic parameters and microvascular hemodynamics after hemorrhagic shock resuscitation was studied in the hamster window chamber model. Moderate hemorrhagic shock was induced by controlled arterial bleeding of 50% of blood volume, and hypovolemia was maintained for 1 hour. Fluid resuscitation was accomplished by infusion of 25% of blood volume and recovery was followed over 90 minutes. The >PEG-Alb (six chains of maleimide phenyl PEG conjugated human serum albumin at 4%) resuscitation group was compared human serum albumin (HSA) at 5% (>HSA5) and 10% (>HSA10) protein concentrations. Systemic parameters, microvascular perfusion and capillary perfusion (functional capillary density, FCD) were measured by noninvasive methods. Hyperoncotic solutions provided rapid restoration of blood pressure, blood gas parameters and microvascular perfusion. Systemic and microvascular recovery was best and most rapid with >PEG-Alb and followed by >HSA10 and >HSA5 rapid. Only recovery with >PEG-Alb was sustained beyond 90 min. Hemodynamic functional benefits of >PEG-Alb and the potential disadvantages associated with HSA, suggest PEG-Alb as better resuscitation solution.