Pyridoxalated Polymerized Stroma-Free Hemoglobin Solution (SFHS-PP) as an Oxygen-Carrying Fluid Replacement for Hemorrhagic Shock in Dogs

摘要

This study examines the effects of modified stroma-free hemoglobin solution as an oxygen-carrying volume support fluid. Dogs were subjected to hemorrhagic shock to a mean arterial pressure (MAP) of 40 torr for 30 minutes, and then resuscitated with pyridoxalated polymerized stroma-free hemoglobin solution (SFHS-PP), lactated Ringer's (LR) solution, or autotransfusion (A) with shed blood. Although for the LR group, the MAP, cardiac output, and mixed venous pO2 had lower means than for the SFHS-PP and A groups, analysis for MAP showed no difference between groups. Heart rate in the SFHS-PP, there was transient elevation (< 7 days) of the liver enzyme SGOT and alkaline phosphatase (< 2 days). No SFHS-PP induced renal glomerular or tubular damage was detected by urine analysis. The PT and PTT were abnormal and thrombocytopenia occurred after SFHS-PP infusion. A transient leukopenia in the SFHS-PP dogs was followed by leukocytosis. Hypoglycemia occurred for 48 hours in the SFHS-PP group, but no other electrolyte abnormalities were noted in any group. Oxygen was carried in the plasma (SFHS-PP fraction) and off-loaded to the tissues. SFHS-PP carried almost half of the total oxygen content of the blood. Arterial and mixed venous pO2 were maintained in the physiologic range. SFHS-PP functions well as a volume replacement and as an oxygen-carrying fluid for resuscitation from hemorrhagic shock without major toxicity; however, no demonstrated advantage of SFHS-PP over LR could be determined.