Resuscitation with the hemoglobin-based oxygen carrier, HBOC-201, in a swine model of severe uncontrolled hemorrhage and traumatic brain injury
The purpose of this investigation was to compare the effects of initial resuscitation with HBOC-201 to that of lactated Ringer (LR) solution in the setting of uncontrolled hemorrhage and traumatic brain injury (TBI). Anesthetized immature swine underwent fluid-percussion TBI and liver laceration. During a 75-min "prehospital phase," the animals were resuscitated with HBOC-201, LR solution, or nothing (NON). Upon "hospital arrival," the animals were provided blood and 0.9% NaCl as needed, and the liver injury was repaired. Surviving animals were killed 6 h after injury. Brain tissue was processed for blood flow, and gross, light microscopic, and immunohistochemical analyses. Mean TBI force (2.6 +/- 0.6 atm) and blood loss (64.4 +/- 3.4 mL/kg) were similar between groups. Six-hour survival was significantly greater in HBOC-201 (8 of 13 [62%]) versus LR solution (1 of 11 [9%]) and NON (1 of 8 [3%]) animals (P < 0.02). Mean arterial pressures, cardiac indices, cerebral perfusion pressures, and brain tissue oxygen tension were significantly greater, and lactate and base deficit were lower in HBOC-201 as compared with LR solution animals. Blood transfusion requirements were reduced in HBOC-201 (3.6 +/- 0.6 mL/kg per survival hour) as compared to 7.1 +/- 1.2 mL/kg per survival hour. Severity of subarachnoid and intraparenchymal hemorrhages was statistically greater in LR solution-treated animals, but these differences were not likely to be clinically significant. There were no differences in glial fibrillary acidic protein and microtubule-associated protein 2. In this model of combined uncontrolled hemorrhage and TBI, initial resuscitation with HBOC-201 resulted in significant improvements in survival and systemic and cerebrovascular physiological parameters, as well as a reduction in transfusion requirements.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2009 |
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| Erschienen: |
2009 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
Shock (Augusta, Ga.) - 31(2009), 1 vom: 27. Jan., Seite 64-79 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Stern, Susan [VerfasserIn] |
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| Links: |
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| Themen: |
1XQE66T19H |
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| Anmerkungen: |
Date Completed 30.03.2009 Date Revised 01.12.2018 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/SHK.0b013e3181778dc3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM179738348 |
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| 100 | 1 | |a Stern, Susan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Resuscitation with the hemoglobin-based oxygen carrier, HBOC-201, in a swine model of severe uncontrolled hemorrhage and traumatic brain injury |
| 264 | 1 | |c 2009 | |
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| 500 | |a Date Completed 30.03.2009 | ||
| 500 | |a Date Revised 01.12.2018 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a The purpose of this investigation was to compare the effects of initial resuscitation with HBOC-201 to that of lactated Ringer (LR) solution in the setting of uncontrolled hemorrhage and traumatic brain injury (TBI). Anesthetized immature swine underwent fluid-percussion TBI and liver laceration. During a 75-min "prehospital phase," the animals were resuscitated with HBOC-201, LR solution, or nothing (NON). Upon "hospital arrival," the animals were provided blood and 0.9% NaCl as needed, and the liver injury was repaired. Surviving animals were killed 6 h after injury. Brain tissue was processed for blood flow, and gross, light microscopic, and immunohistochemical analyses. Mean TBI force (2.6 +/- 0.6 atm) and blood loss (64.4 +/- 3.4 mL/kg) were similar between groups. Six-hour survival was significantly greater in HBOC-201 (8 of 13 [62%]) versus LR solution (1 of 11 [9%]) and NON (1 of 8 [3%]) animals (P < 0.02). Mean arterial pressures, cardiac indices, cerebral perfusion pressures, and brain tissue oxygen tension were significantly greater, and lactate and base deficit were lower in HBOC-201 as compared with LR solution animals. Blood transfusion requirements were reduced in HBOC-201 (3.6 +/- 0.6 mL/kg per survival hour) as compared to 7.1 +/- 1.2 mL/kg per survival hour. Severity of subarachnoid and intraparenchymal hemorrhages was statistically greater in LR solution-treated animals, but these differences were not likely to be clinically significant. There were no differences in glial fibrillary acidic protein and microtubule-associated protein 2. In this model of combined uncontrolled hemorrhage and TBI, initial resuscitation with HBOC-201 resulted in significant improvements in survival and systemic and cerebrovascular physiological parameters, as well as a reduction in transfusion requirements | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 7 | |a Blood Substitutes |2 NLM | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 650 | 7 | |a Isotonic Solutions |2 NLM | |
| 650 | 7 | |a Ringer's Lactate |2 NLM | |
| 650 | 7 | |a HBOC 201 |2 NLM | |
| 650 | 7 | |a 1XQE66T19H |2 NLM | |
| 700 | 1 | |a Rice, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Philbin, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a McGwin, Gerald |e verfasserin |4 aut | |
| 700 | 1 | |a Arnaud, Françoise |e verfasserin |4 aut | |
| 700 | 1 | |a Johnson, Todd |e verfasserin |4 aut | |
| 700 | 1 | |a Flournoy, W Shannon |e verfasserin |4 aut | |
| 700 | 1 | |a Ahlers, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Pearce, L Bruce |e verfasserin |4 aut | |
| 700 | 1 | |a McCarron, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Freilich, Daniel |e verfasserin |4 aut | |
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