Hemorrhagic shock resuscitation using a polymerized hemoglobin oxygen carrier versus whole blood (707.5)

Liposome-encapsulated hemoglobin (LHb), which is structurally similar to red blood cells (RBC) except smaller size (250 nm), can serve as blood substitute comparable to RBC. We have reported that intraosseous blood infusion (IOI) is effective treatment in shock mice model. IOI is alternative to peripheral i.v. infusion and is expected as an important field treatment in civilian emergency because of no collapse of intramedullary blood vessels in the bone marrow in shock. However, we did not evaluate the side effects of LHb in IOI. Total 70% hemorrhagic shock was induced by femoral vein bleeding. Immediately after bleeding, 17 mice were resuscitated with tibial bone IOI of 5% albumin (5% albumin), 18 mice resuscitated with mouse-washed RBC (Wash RBC) and 14 mice resuscitated with LHb (LHb-group). Survival rates were compared and the temporal changes in cytokins (TNF, INFγ) as well as liver and renal function (s-ALT, s-creatinine) were measured. All mice survived 48 h after IOI of LHb whereas only 47% and 45% mice survived in 5% albumin and Wash RBC, respectively (Fig. 1 ). The changes in TNF and INFγlevels after IOI were not statistically different among 3 groups (Fig. 2 ) and no side effects were found on liver and renal function.. Conclusions: LHb has a better anti-shock effect than RBC by using IOI probably due to smaller size and IOI of LHb could be useful in disaster medicine. In addition, IOI of LHb shows no significant effects on cytokins, liver and renal function. Figure 1 Figure 2

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Use of levarterenol in treatment of irreversible hemorrhagic shock

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1959.196.5.1029 ◽

1959 ◽

Vol 196 (5) ◽

pp. 1029-1032 ◽

Cited By ~ 3

Author(s):

H. A. Fozzard ◽

J. P. Gilmore

Keyword(s):

Hemorrhagic Shock ◽

Survival Time ◽

Whole Blood ◽

Hemorrhagic Hypotension ◽

Effective Adjunct

The effectiveness of levarterenol in the treatment of shock resulting from prolonged oligemia was studied in the dog. The survival time of animals receiving levarterenol and whole blood therapy was significantly greater than that of animals receiving a placebo and whole blood. The results of the experiments indicate that levarterenol is an effective adjunct to whole blood therapy in the treatment of shock resulting from prolonged hemorrhagic hypotension.

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Systemic and microcirculatory effects of autologous whole blood resuscitation in severe hemorrhagic shock

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1999.276.6.h2035 ◽

1999 ◽

Vol 276 (6) ◽

pp. H2035-H2043 ◽

Cited By ~ 16

Author(s):

Heinz Kerger ◽

Klaus F. Waschke ◽

Klaus V. Ackern ◽

Amy G. Tsai ◽

Marcos Intaglietta

Keyword(s):

Metabolic Acidosis ◽

Hemorrhagic Shock ◽

Whole Blood ◽

Tissue Perfusion ◽

Capillary Density ◽

Shed Blood ◽

Syrian Golden Hamsters ◽

Autologous Whole Blood ◽

Significant Impairment ◽

Main Determinants

Systemic and microcirculatory effects of autologous whole blood resuscitation after 4-h hemorrhagic shock with a mean arterial pressure (MAP) level of 40 mmHg were investigated in 63 conscious Syrian golden hamsters. Microcirculation of skeletal skin muscle and subcutaneous connective tissue was visualized in a dorsal skinfold. Shed blood was retransfused within 30 min after 4 h. Animals were grouped into survivors in good (SG) and poor condition (SP) and nonsurvivors (NS) according to 24-h outcome after resuscitation and studied before shock, during shock (60, 120, and 240 min), and 30 min and 24 h after resuscitation. Microvascular and interstitial[Formula: see text] values were determined by phosphorescence decay. Shock caused a significant increase of arterial[Formula: see text] and decrease of[Formula: see text], pH, and base excess. In the microcirculation, there was a significant decrease in blood flow (Q˙B), functional capillary density (FCD; capillaries with red blood cell flow), and interstitial [Formula: see text][1.8 ± 0.8 mmHg (SG), 1.3 ± 1.3 mmHg (SP), and 0.9 ± 1.1 mmHg (NS) vs. 23.0 ± 6.1 mmHg at control]. Blood resuscitation caused immediate MAP recompensation in all animals, whereas metabolic acidosis, hyperventilation, and a significant interstitial [Formula: see text] decrease (40–60% of control) persisted. In NS (44.4% of the animals), systemic and microcirculatory alterations were significantly more severe both in shock and after resuscitation than in survivors. Whereas in SG (31.8% of the animals) there was only a slight (15–30%) but still significant impairment of microscopic tissue perfusion (Q˙B, FCD) and oxygenation at 24 h, SP (23.8% of the animals) showed severe metabolic acidosis and substantial decreases (≥50%) of FCD and interstitial[Formula: see text]. FCD, interstitial[Formula: see text], and metabolic state were the main determinants of shock outcome.

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