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CARDIOVASCULAR ANESTHESIA

A Novel Approach to Measuring Circulating Blood Volume: The Use of a Hemoglobin-Based Oxygen Carrier in a Rabbit Model

Jonathan S. Jahr, MD^*, Fedor Lurie, MD, PhD^*, Side Xi, PhD, Mohammad Golkaryeh, MD^*, Olga Kuznetsova, MD^*, Ravjeet Kullar, and Bernd Driessen, DVM, PhD

Departments of *Anesthesiology and Pain Medicine and Pediatrics, University of California-Davis, Sacramento, California; and Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania

Address correspondence and reprint requests to J. S. Jahr, MD, Department of Anesthesiology, UC Davis Medical Center, 4150 V St., Ste. 1200, Sacramento, CA 95817.

Hemoglobin-based oxygen carriers (HBOC) may be ideal for monitoring circulating plasma volume (CV-P) and circulating blood volume (CV-B). We used an HBOC (Hemoglobin glutamer-200 [bovine], Oxyglobin®; Biopure, Cambridge, MA) as an indicator for relative CV-B in the rabbit model. Accuracy of the technique was determined by comparison with the Evans blue dye (EBD) dilution technique in 19 anesthetized female New Zealand rabbits weighing 2.0 to 10.6 kg. The measurements were performed at baseline, after hemorrhage (1/3 of CV-B), normovolemic hemodilution (replacement of 1/3 CV-B by Hextend®; Abbot Laboratories, North Chicago, IL), and hypervolemic hemodilution (additional infusion of Hextend® in a volume equal to 1/3 of CV-B). Hemoglobin concentration was measured by using a HemoCue® photometer (HemoCue AB, Angelholm, Sweden). EBD concentration was analyzed by using linear regression to estimate Time 0 concentration; Time 0 was defined as EBD injection time. The difference between CV-P values determined by EBD and HBOC dilution was independent from the magnitude of the CV-P value. The relative bias was 1.29 mL, and the precision (one SD) was 2.82 mL. The difference did not reach statistical significance.

Implications: Circulating plasma and blood volumes can be accurately estimated by plasma hemoglobin concentration measurements by using hemoglobin-based oxygen carrier infusion.

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