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Enhanced central organ oxygenation after application of bovine cell-free hemoglobin HBOC-201

[Amélioration de l’oxygénation des organes centraux après l’usage d’hémoglobine bovine acellulaire HBOC-201]

Marc Freitag, MD^*, Thomas G. Standl, MD^*, André Gottschalk, MD^*, Marc A. Burmeister, MD^*, Christian Rempf, MD^*, Ernst P. Horn, MD^*, Tim Strate, MD and Jochen Schulte am Esch, MD^*

^* From the Departments of Anesthesiology, and
Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Address correspondence to: Dr. Marc Freitag, Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. Phone: +49 40 42803 4409; Fax: +49 40 42803 7631; E-mail: freitag{at}uke.uni-hamburg.de

Purpose: While the effects of dilutional anemia or isovolemic hemodilution (IHD) on the oxygen extraction and tissue oxygenation in peripheral organs after application of hemoglobin-based oxygen carriers like HBOC-201 have been studied intensively, little is known about tissue oxygenation properties of hemoglobin solutions in central organs like the liver.

Methods: Twelve Foxhounds were anesthetized and then randomized to either a control group without hemodilution (Group 1) or underwent first step isovolemic hemodilution (pulmonary artery occlusion pressure constant) with Ringer’s solution (Group 2) to a hematocrit of 25% with second step infusion of HBOC-201 until a hemoglobin concentration of +0.6 g·dL^–1 was reached. Tissue oxygen tensions (tpO₂) were measured in the gastrocnemius muscle using a polarographic needle probe, and in the liver using a flexible polarographic electrode.

Results: While arterial oxygen content and oxygen delivery decreased with hemodilution in Group 2, global liver and muscle oxygen extraction ratio increased after hemodilution and additional application of HBOC-201. Hemodilution and application of HBOC-201 provided augmentation of the mean liver tpO₂ (baseline: 48 ± 9, 20 min: 53 ± 10, 60 min: 67 ± 11*, 100 min: 68 ± 7*; *P < 0.05 vs baseline and Group 1), while oxygen tensions in Group 1 remained unchanged. Oxygen tension in the skeletal muscle increased after hemodilution and additionally after application of HBOC-201 in comparison to baseline and to the control group (P < 0.05).

Conclusion: In the present animal model, IHD with Ringer’s solution and additional application of HBOC-201 increased oxygen extraction and tpO₂ in the liver and skeletal muscle, in parallel and in comparison with baseline values and a control group.

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				R. I. Hall The utility of hemoglobin based oxygen carriers (HBOC) - can animal studies help?/L'utilite des transporteurs d'oxygene a base d'hemoglobine (HBOC) - les etudes animales peuventelles aider ? Can J Anesth, November 1, 2005; 52(9): 895 - 898. [Full Text] [PDF]