Bovine polymerized hemoglobin (hemoglobin-based oxygen carrier-201) resuscitation in three swine models of hemorrhagic shock with militarily relevant delayed evacuation—Effects on histopathology and organ function*

2006 ◽  
Vol 34 (5) ◽  
pp. 1464-1474 ◽  
Author(s):  
Todd Johnson ◽  
Francoise Arnaud ◽  
Feng Dong ◽  
Nora Philbin ◽  
Jennifer Rice ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Oxygen Carrier ◽  
Organ Function ◽  
Polymerized Hemoglobin

scholarly journals A Novel Cross-Linked Hemoglobin-Based Oxygen Carrier, YQ23, Extended the Golden Hour for Uncontrolled Hemorrhagic Shock in Rats and Miniature Pigs

2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Kuang ◽  
Yu Zhu ◽  
Yue Wu ◽  
Kunlun Tian ◽  
Xiaoyong Peng ◽  
...  
Keyword(s):  
Side Effects ◽  
Hemorrhagic Shock ◽  
Damage Control ◽  
Oxygen Carrier ◽  
Organ Injury ◽  
Damage Control Resuscitation ◽  
Organ Function ◽  
Golden Hour ◽  
Animal Survival ◽  
Hypotensive Resuscitation

Background: Hypotensive resuscitation is widely applied for trauma and war injury to reduce bleeding during damage-control resuscitation, but the treatment time window is limited in order to avoid hypoxia-associated organ injury. Whether a novel hemoglobin-based oxygen carrier (HBOC), YQ23 in this study, could protect organ function, and extend the Golden Hour for treatment is unclear.Method: Uncontrolled hemorrhagic shock rats and miniature pigs were infused with 0.5, 2, and 5% YQ23 before bleeding was controlled, while Lactate Ringer’s solution (LR) and fresh whole blood plus LR (WB + LR) were set as controls. During hypotensive resuscitation the mean blood pressure was maintained at 50–60 mmHg for 60 min. Hemodynamics, oxygen delivery and utilization, blood loss, fluid demand, organ function, animal survival as well as side effects were observed. Besides, in order to observe whether YQ23 could extend the Golden Hour, the hypotensive resuscitation duration was extended to 180 min and animal survival was observed.Results: Compared with LR, infusion of YQ23 in the 60 min pre-hospital hypotensive resuscitation significantly reduced blood loss and the fluid demand in both rats and pigs. Besides, YQ23 could effectively stabilize hemodynamics, and increase tissue oxygen consumption, increase the cardiac output, reduce liver and kidney injury, which helped to reduce the early death and improve animal survival. In addition, the hypotensive resuscitation duration could be extended to 180 min using YQ23. Side effects such as vasoconstriction and renal injury were not observed. The beneficial effects of 5% YQ23 are equivalent to similar volume of WB + LR.Conclusion: HBOC, such as YQ23, played vital roles in damage-control resuscitation for emergency care and benefited the uncontrolled hemorrhagic shock in the pre-hospital treatment by increasing oxygen delivery, reducing organ injury. Besides, HBOC could benefit the injured and trauma patients by extending the Golden Hour.

A Comparison of the Hemoglobin-Based Oxygen Carrier HBOC-201 to Other Low-Volume Resuscitation Fluids in a Model of Controlled Hemorrhagic Shock

2003 ◽  
Vol 55 (4) ◽  
pp. 747-754 ◽  
Author(s):  
CPT James B. Sampson ◽  
CPT Michael R. Davis ◽  
MAJ Deborah L. Mueller ◽  
LT Vikram S. Kashyap ◽  
LT Donald H. Jenkins ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Oxygen Carrier ◽  
Volume Resuscitation ◽  
Low Volume

Abstract 4030: Resuscitation with Intraosseous Infusion of Artificial Oxygen Carrier of Liposome-Encapsulated Hemoglobin (LHb) from Lethal Hemorrhagic Shock and Its Effect on Cytokines

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Bonpei Takase ◽  
Satoshi Shono ◽  
Manabu Kinoshita ◽  
Yashiro Nogami ◽  
Yoshitaka Ogata ◽  
...  
Keyword(s):  
Renal Function ◽  
Side Effects ◽  
Hemorrhagic Shock ◽  
Oxygen Carrier ◽  
Femoral Vein ◽  
Survival Rates ◽  
Blood Substitute ◽  
Disaster Medicine ◽  
Mice Model ◽  
Artificial Oxygen Carrier

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

Controlled Polymerization and Ultrafiltration Increase the Consistency of Polymerized Hemoglobin for Use as an Oxygen Carrier

2019 ◽  
Vol 31 (3) ◽  
pp. 605-621 ◽  
Author(s):  
Donald A. Belcher ◽  
Clayton T. Cuddington ◽  
Evan L. Martindale ◽  
Ivan S. Pires ◽  
Andre F. Palmer
Keyword(s):  
Oxygen Carrier ◽  
Controlled Polymerization ◽  
Polymerized Hemoglobin

Coagulation and Resuscitation Patterns Following Transfusion with Polymerized Hemoglobin Based Oxygen Carrier (HBOC-201) after Severe Hemorrhage in Swine.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2704-2704
Author(s):  
Francoise Arnaud ◽  
Michael Hammett ◽  
Nora Philbin ◽  
Jennifer Rice ◽  
Frank Dong ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Bleeding Time ◽  
Oxygen Carrier ◽  
Hematological Parameters ◽  
Blood Substitutes ◽  
Combat Trauma ◽  
Blood Transfusions ◽  
Transfusion Requirements ◽  
Resuscitation Fluid

Abstract INTRODUCTION: Blood substitutes can alleviate problems related to blood typing and blood availability in civilian and combat trauma casualties. The aim of this study was to assess the effect of transfusions of a blood substitute, HBOC-201 (Biopure Corp, Cambridge, MA) (HBOC), as a resuscitation fluid in severe controlled hemorrhagic shock (HS). METHODS: Yucatan pigs underwent a 55% EBV controlled hemorrhage by catheter withdrawal. Animals (n=24) were either non-resuscitated (NON) or resuscitated with HBOC or with buffered hydroxyethyl starch (HEX) at an initial rate of 10 ml/kg. Additional infusions were given at 5 ml/kg if hypotension or tachycardia persisted during the 4 hr period following HS. Thereafter, animals received simulated hospital care up to 72 hr with access to blood transfusions for Hb < 7g/dl. In-vivo parameters (vital signs and in vivo bleeding time (BT)), as well as coagulation (PT, PTT, fibrinogen), thromboelastography (TEG) and in vitro bleeding time (PFA-CT) were assayed on blood samples obtained at various times after HS. RESULTS: Although not statistically significant, HBOC allowed 100% survival compared to 75% with HEX and 25% for NON. It also restored the mean arterial pressure more rapidly compared to HEX. HBOC and HEX groups received similar resuscitation fluid volumes and showed similar hemodilution during the prehospital phase with comparable BT. PFA-CT increased abruptly for both groups remaining elevated at 24 h for HBOC. Other hemostasis parameters were better controlled in the HBOC group compared to HEX: TEG-MA was less suppressed and PT was lower with HBOC. TEG-R was unchanged but indicated delayed hypocoagulation in the HBOC group by 24 hr. At simulated hospital arrival 4 hr after HS, only 10% of animals in the HBOC group required blood transfusions compared to 100% in HEX group. By 72 hr most hematological parameters returned to normal. CONCLUSIONS: Although HBOC-201 caused less coagulopathy than HEX during fluid resuscitation, it resulted in mild, delayed, and transient coagulopathy by 24 hr. Moreover, HBOC-201 reduced blood transfusion requirements, supporting use of this oxygen-carrying fluid for hemorrhagic shock. The opinions contained herein are the ones of the authors and are not to be construed as official or reflecting the views of the Navy department or the naval service at large. Figure Figure

Sign in / Sign up

Export Citation Format

Share Document