Intraosseous Erythropoietin for Acute Tissue Protection in Battlefield Casualties Suffering Hypovolemic Shock
Technical Report,04 Oct 2010,03 Apr 2015
Rosalind Franklin University of Medicine and Science North Chicago United States
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The original project was designed to determining whether erythropoietin EPO administered intraosseously 1,200 Ukgduring hemorrhagic shock in a swine model could provide tissue protection and promote survival. Several experimental series were conducted during the 4 year duration of the project. Initially, controlled removal of 50 of blood volume yielded88 resuscitability and 60 survival at 72 hours, unaffected by EPO. Controlled removal of 65 of blood volume yielded25 resuscitability, but again unaffected by EPO. The model was then modified incorporating early and sustained infusion of vasopressin, also intraosseously 0.04 Ukgmin-1 to improve survival for the same 65 blood volume removal. Resuscitability markedly increased to 92 leading to 83 survival at 72 hour with EPO showing a possible beneficial effect on organ function but without a survival effect. While conducting these experiments, we adopted restrictive fluid resuscitation reducing the 0.9 NaCl volume given during resuscitation from threefold the blood volume removed in the initial two series to half the blood volume removed in the third series observing that vasopressin infusion promoted remarkable hemodynamic stability and enabled restrictive fluid resuscitation.