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Anesth Analg 2005;100:912-920
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000146960.79532.DB

CARDIOVASCULAR ANESTHESIA

Systemic Responses to Hemodilution After Transfusion with Stored Blood and with a Hemoglobin-Based Oxygen Carrier

Ivo P. Torres Filho, MD, PhD*{dagger}{ddagger}, Bruce D. Spiess, MD*{dagger}, R. Wayne Barbee, PhD{dagger}{ddagger}, Kevin R. Ward, MD{dagger}{ddagger}, John Oldenhof, PhD§, and Roland N. Pittman, PhD{dagger}{ddagger}

Departments of *Anesthesiology, {dagger}Emergency Medicine, and {ddagger}Physiology, Virginia Commonwealth University Reanimation Engineering Shock Center, Virginia Commonwealth University Medical Center, Richmond, Virginia; and §Hemosol Inc., Toronto, Ontario, Canada

Address correspondence and reprint requests to Ivo P. Torres Filho, MD, PhD, Department of Anesthesiology, MCV-VCU, 1101 E. Marshall St., Room B1-012, Richmond, VA 23298. Address e-mail to itorres{at}vcu.edu.

We assessed the systemic effects of exchanges with blood or hemoglobin (Hb) raffimer under conditions of critical oxygen delivery (Do2crit). We compared Do2crit in animals receiving Hb-based oxygen carrier (HBOC; HemolinkTM), fresh blood (collected <24 h), or stored blood (10 days) before hemodilution. Rats were randomized to control, blood, or HBOC isovolemic exchange. Oxygen consumption was measured by using expired gas (Vo2a) and blood (Vo2b) samples, whereas whole-body oxygen delivery (Do2) was calculated from cardiac output and arterial oxygen content. After exchange, rats were subjected to stepwise isovolemic hemodilution. Blood pressure, gases, acid-base status, glucose, Hb oxygen saturation, heart rate, and total peripheral resistance were also measured. We found that 1) HBOC-treated rats showed an increased mean arterial blood pressure and total peripheral resistance throughout the hemodilution, 2) Do2crit calculated with Vo2a or Vo2b gave identical results, 3) Do2crit was not different between animals receiving blood and those receiving HBOC, 4) the terminal Hb concentration (1.8 ± 0.1 g/dL) and Do2 (5 ± 1 mL · min–1 · kg–1) were similar for all animals, and 5) most oxygen transport and biochemical variables changed similarly during hemodilution. The data suggest that tolerance to Do2crit is not altered by 50% replacement of native Hb by stored blood or Hb raffimer.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.