Bovine hemoglobin-based oxygen carrier (HBOC-201) for resuscitation of uncontrolled, exsanguinating liver injury in swine. Carolina Resuscitation Research Group.
Bovine hemoglobin-based oxygen carrier (HBOC-201) for resuscitation of uncontrolled, exsanguinating liver injury in swine. Carolina Resuscitation Research Group.
复制标题
基于牛血红蛋白的氧载体 (HBOC-201)，用于猪不受控制的失血性肝损伤的复苏。
DOI：
10.1097/00024382-200013020-00010
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发表时间：
2000
期刊：
影响因子：
3.1
通讯作者：
C. Baker
中科院分区：
文献类型：
--
作者：
J. E. Manning;L. Katz;M. Brownstein;L. Pearce;M. Gawryl;C. Baker
在快速失血的情况下，在同种异体输血和手术之前，使用静脉内 (i.v.) 晶体溶液进行复苏可能无法维持生存。这项研究检验了基于牛血红蛋白的氧载体 HBOC-201 可以改善复苏并延长失血后早期生存的假设。这项研究模拟了院前快速失血的场景，院前时间较长且血液供应不足。通过多处肝脏撕裂导致猪严重失血性休克。出血发生后 9 分钟，猪被随机接受约 10 mL/kg/min 的静脉注射。乳酸林格氏液 (n = 10) 或 HBOC-201 (n = 7) 以获得 60 mmHg 的平均主动脉压 (MAP)。此后，调整输注速度以将 MAP 维持在 60 mmHg 长达 2 小时。所有动物最初均成功复苏。结果显示，使用乳酸林格氏液的 2 小时存活率为 10 例，使用 HBOC-201 的 2 小时存活率为 7 例（P = 0.0004）。 9 头哺乳林格氏猪在 36 +/- 10 分钟时出现心血管衰竭。 30 分钟时乳酸林格氏液为 18 +/- 3 mmol/L，HBOC-201 为 12 +/- 2 mmol/L (P < 0.05)。 10 只哺乳林格氏病动物中的 9 只和 7 只 HBOC-201 动物中的 6 只的血细胞比容 <1%。这些数据表明，在这种猪肝损伤模型中，与无法控制的致死性出血的乳酸林格氏病相比，HBOC-201 改善了早期存活率并稳定了血流动力学和代谢参数，该模型模拟了无法获得同种异体血液的院前护理环境。
In the setting of rapidly exsanguinating hemorrhage, resuscitation with intravenous (i.v.) crystalloid solution may not sustain survival before availability of allogenic blood transfusion and surgery. This study tested the hypothesis that bovine hemoglobin-based oxygen carrier, HBOC-201, would improve resuscitation and extend early survival from exsanguinating hemorrhage. This study simulated the prehospital scenario of rapidly exsanguinating hemorrhage with prolonged prehospital time and lack of blood availability. Severe hemorrhagic shock was induced in swine by using multiple liver lacerations. At 9 min after the onset of bleeding, swine were randomized to receive approximately 10 mL/kg/min of i.v. lactated Ringer's solution (n = 10) or HBOC-201 (n = 7) to achieve a mean aortic pressure (MAP) of 60 mmHg. Thereafter, infusion rate was adjusted to maintain MAP at 60 mmHg for up to 2 h. All animals were initially successfully resuscitated. The results showed 2-h survival was 1 of 10 with lactated Ringer's and 7 of 7 with HBOC-201 (P = 0.0004). Nine lactated Ringer's swine had cardiovascular collapse at 36 +/- 10 min. Lactate at 30 min was 18 +/- 3 mmol/L with lactated Ringer's and 12 +/- 2 mmol/L with HBOC-201 (P < 0.05). Hematocrit was <1% in 9 of 10 lactated Ringer's and 6 of 7 HBOC-201 animals. These data indicate that HBOC-201 improved early survival and stabilized hemodynamic and metabolic parameters vs. lactated Ringer's in this swine model of liver injury with uncontrolled, lethal hemorrhage that simulates the prehospital care environment where allogenic blood is unavailable.