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Diaspirin Cross-Linked Hemoglobin Infusion Did Not Influence Base Deficit and Lactic Acid Levels in Two Clinical Trials of Traumatic Hemorrhagic Shock Patient Resuscitation

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Diaspirin cross-linked hemoglobin DCLHb has demonstrated a pressor effect that could adversely affect traumatic hemorrhagic shock patients through diminished perfusion to vital organs, causing base deficit BD and lactate abnormalities. Methods Data from two parallel, multicenter traumatic hemorrhagic shock clinical trials from 17 US Emergency Departments and 27 European Union prehospital services using DCLHb, a hemoglobin-based resuscitation ftuid. Results In the 219 patients, the mean age was 37.3 years, 64 of the patients sustained a blunt injury, 48 received DCLHb resuscitation, and the overall 28-day mortality rate was 36.5. BD data did not differ by treatment group DCLHb vs. normal saline NS at any time point. Study entry BD was higher in patients who died when compared with survivors in both studies US -14.7 vs. -9.3 and European Union -11.1 vs. -4.1 mEqL, p 0.003 and at the first three time points after resuscitation. No differences in BD based on treatment group were observed in either those who survived or those who died from the hemorrhagic shock. US lactate data did not differ by treatment group DCLHb vs. NS at any time point. Study entry lactates were higher in US patients who ultimately died when compared with survivors 82.4 vs. 56.1 mmoiL, p 0.003 and at all five postresuscitation time points. No lactate differences were observed between DCLHb and NS survivors or in those who died based on treatment group. Conclusions Although patients who died had more greatly altered perfusion than those who survived, DCLHb treatment of traumatic hemorrhagic shock patients was not associated with BD or lactate abnormalities that would indicate poor perfusion.

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  • Biochemistry
  • Medicine and Medical Research

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