Accession Number : ADA469050


Title :   A Hemoglobin-based Oxygen Carrier, Bovine Polymerized Hemoglobin (HBOC-201) Versus Hetastarch (HEX) in a Moderate Severity Hemorrhagic Shock Swine Model with Delayed Evacuation


Descriptive Note : Journal article


Corporate Author : NAVAL MEDICAL RESEARCH CENTER SILVER SPRING MD


Personal Author(s) : Philbin, Nora ; Rice, Jennifer ; Gurney, Jennifer ; McGwin, Gerald ; Arnaud, Francoise ; Dong, Feng ; Johnson, Todd ; Flourncy, W S ; Ahlers, Stephen ; Pearce, L B ; McCarron, Richard ; Freilich, Daniel


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a469050.pdf


Report Date : 23 Mar 2005


Pagination or Media Count : 13


Abstract : Objective: To evaluate the efficacy of HBOC-201 for resuscitation of hemorrhagic shock in a swine model incorporating soft tissue injury and delayed evacuation. Methods: A muscle crush injury and 40% estimated blood volume controlled hemorrhage was completed in 24 Yucatan mini-pigs. Pigs were untreated or resuscitated with HBOC-201 or 6% hetastarch (HEX) at 20 min. Invasive hemodynamics and clinical variables were monitored for 4 h (pre-hospital phase) and subsequent fluid infusions were administered for severe hypotension or tachycardia. Animals were recovered from anesthesia and monitored non-invasively to 72 h (hospital phase). Results: 100% (8/8) of HBOC-201-, 88% (7/8) of HEX-, and 63% (5/8) of non-resuscitated pigs, survived to 72 h (p = 0.27). Mean arterial pressure, mean pulmonary arterial pressure and systemic vascular resistance index were higher in HBOC-201 pigs. By 90 min, cardiac index was restored to baseline in the HBOC-201 group and was 1.4-fold greater than baseline in the HEX group. HBOC-201 pigs had lower fluid requirements than HEX pigs (18.8 1.8 and 29.9 1.1 ml/kg, p 0.001) in the pre-hospital phase and required fewer blood transfusions (1.3 1.3 and 9.4 0.6 ml/kg, respectively, p 0.001) in the hospital phase. Urine output and blood creatinine were comparable in HBOC-201 and HEX pigs. Tissue oxygenation levels were highest in the HBOC-201 group. Conclusions: As HBOC-201 restored hemodynamics and tissue oxygenation and decreased fluid requirements, in comparison with HEX, HBOC-201 was at least as efficacious and possibly a superior resuscitative fluid in a military-relevant delayed evacuation hemorrhagic shock swine model.


Descriptors :   *OXYGEN , *WOUNDS AND INJURIES , *BLOOD CIRCULATION , *HEMORRHAGIC SHOCK , *HEMOGLOBIN , *RESUSCITATION , *SWINE , OUTPUT , REPRINTS , LUNG , CARDIOVASCULAR SYSTEM , ANESTHESIA , CREATININE , INFUSIONS , SOFT TISSUES , PERFUSION , BLOOD TRANSFUSION , BLOOD PRESSURE , TACHYCARDIA , URINE , HEART , HOSPITALS , MUSCLES , ANIMALS , TISSUES(BIOLOGY) , CLINICAL MEDICINE


Subject Categories : Biochemistry
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE