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CARDIOVASCULAR ANESTHESIA

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

Ivo P. Torres Filho, MD, PhD^*, Bruce D. Spiess, MD^*, R. Wayne Barbee, PhD, Kevin R. Ward, MD, John Oldenhof, PhD, and Roland N. Pittman, PhD

Departments of *Anesthesiology, Emergency Medicine, and 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; Hemolink^TM), 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 (o₂a) and blood (o₂b) 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 o₂a or o₂b 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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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