Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles.
Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles.
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Hb 囊泡对失血性休克和复苏的全身和微血管反应。
DOI：
10.1152/ajpheart.00080.2002
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Tsuchida,Eishun
中科院分区：
文献类型：
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作者：
Sakai,Hiromi;Takeoka,Shinji;Wettstein,Reto;Tsai,AmyG;Intaglietta,Marcos;Tsuchida,Eishun
已开发出封装血红蛋白的磷脂囊泡（Hb囊泡，HbV）以向血浆膨胀剂提供携氧能力。在清醒仓鼠背部皮褶窗制备中评价其恢复失血性休克后全身和微循环条件的能力。将HbV悬浮于8%人血清白蛋白（HSA）中，Hb浓度为3.8 g/dl [HbV（3.8）/HSA]和7.6 g/dl [HbV（7.6）/HSA]。通过50%的失血量诱导休克，并通过额外的失血量将平均动脉压（MAP）维持在40 mmHg持续1 h。接受HbV（3.8）/HSA或HbV（7.6）/HSA悬浮液的仓鼠分别将MAP恢复至93 ± 14和93 ± 10 mmHg，与接受流出血的仓鼠（98 ± 13 mmHg）相似，与单独用HSA复苏（62 ± 12 mmHg）相比显著更高。只有HSA组倾向于在复苏后维持过度通气和负碱过剩。在休克期间，皮下微血管血流量减少至基线的10-20%，流出血的再输注使血流量恢复至基线的10 -80%，这主要是由于小动脉A0（直径143 ± 29 μm）的持续收缩所致。HbV（3.8）/HSA组的微血管血流恢复明显优于HSA组，组织氧合无明显改善。碱过量的恢复和组织氧合的改善似乎主要是由于HbV液体复苏的携氧能力增加。
A phospholipid vesicle encapsulating hemoglobin (Hb vesicle, HbV) has been developed to provide O2-carrying capacity to plasma expanders. Its ability to restore systemic and microcirculatory conditions after hemorrhagic shock was evaluated in the dorsal skinfold window preparation of conscious hamsters. The HbV was suspended in 8% human serum albumin (HSA) at Hb concentrations of 3.8 g/dl [HbV(3.8)/HSA] and 7.6 g/dl [HbV(7.6)/HSA]. Shock was induced by 50% blood withdrawal, and mean arterial pressure (MAP) at 40 mmHg was maintained for 1 h by the additional blood withdrawal. The hamsters receiving either HbV(3.8)/HSA or HbV(7.6)/HSA suspensions restored MAP to 93 ± 14 and 93 ± 10 mmHg, respectively, similar with those receiving the shed blood (98 ± 13 mmHg), which were significantly higher by comparison with resuscitation with HSA alone (62 ± 12 mmHg). Only the HSA group tended to maintain hyperventilation and negative base excess after the resuscitation. Subcutaneous microvascular blood flow reduced to ∼10–20% of baseline during shock, and reinfusion of shed blood restored blood flow to ∼60–80% of baseline, an effect primarily due to the sustained constriction of small arteries A0(diameter 143 ± 29 μm). The HbV(3.8)/HSA group had significantly better microvascular blood flow recovery and nonsignificantly better tissue oxygenation than of the HSA group. The recovery of base excess and improved tissue oxygenation appears to be primarily due to the increased oxygen-carrying capacity of HbV fluid resuscitation.