JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Moon, P. F. Articles by Nathanielsz, P. W. Search for Related Content PubMed PubMed Citation Articles by Moon, P. F. Articles by Nathanielsz, P. W.

---

OBSTETRIC ANESTHESIA

Fetal Oxygen Content is Restored After Maternal Hemorrhage and Fluid Replacement with Polymerized Bovine Hemoglobin, but Not with Hetastarch, in Pregnant Sheep

Paula F. Moon, DVM, Dipl ACVA^*, Stuart P. Bliss, DVM, Lysa P. Posner, DVM, Hollis N. Erb, DVM, PhD, and Peter W. Nathanielsz, MD, PhD

*Department of Clinical Sciences, The Cornell University Hospital for Animals, the Department of Population Medicine and Diagnostic Sciences, and the Laboratory for Pregnancy and Newborn Research, College of Veterinary Medicine, Cornell University, Ithaca, New York

Address correspondence to Paula F. Moon, DVM, DACVA, C3 105 VMC, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853-6401. Address e-mail to pfm4{at}cornell.edu Reprints are not available.

We investigated the ability of hemoglobin-based oxygen carrying solutions (HBOCs) to alleviate fetal hypoxemia from maternal hemorrhage. Fifteen pregnant ewes (132-day gestational age) were hemorrhaged 20 mL/kg over 1 h; they were randomized to receive 20 mL/kg IV of HBOC, hetastarch (HTS), or autologous blood (BLD) (n = 5 each) over 30 min and were monitored for 2 h. Hemorrhage significantly (P 0.05) decreased maternal mean blood pressure (from 98 to 48 mm Hg, median), arterial oxygen content (from 12.2 to 11.1 mL/dL), and fetal arterial oxygen content (from 8.1 to 3.9 mL/dL). Fluid replacement restored maternal blood pressure in all groups, although maternal oxygen content immediately returned to baseline only after BLD or HBOC. Maternal oxygen saturation decreased after HBOC (from 98% to 88%). Fetal oxygen content rapidly returned to baseline with either BLD (7.1 mL/dL) or HBOC (8.0 mL/dL) but was never restored with HTS (4.7 mL/dL), and, 60 min after fluid replacement, it was higher with HBOC (8.3 mL/dL) than with HTS (4.7 mL/dL). Fetal plasma-free hemoglobin did not change after HBOC. In conclusion, maternal fluid replacement with HBOC or BLD effectively restored fetal oxygenation, primarily by restoring maternal oxygen content, whereas HTS did not.

Implications: Hemoglobin solutions eliminate many limitations of blood transfusions. Ourresults show that fluid replacement with either blood or a hemoglobinsolution, compared with hetastarch, restored fetal oxygenation in pregnantewes after hemorrhage. If applicable to women, these results suggest apotential for the use of hemoglobin solutions in obstetrics.

This article has been cited by other articles:

				S. Neragi-Miandoab and G.J. Vlahakes Elevated troponin I level with hemoglobin based oxygen carrying solutions (HBOCs) as a priming solution despite improved left ventricular function Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 135 - 138. [Abstract] [Full Text] [PDF]

				H. Sakai, S. Takeoka, R. Wettstein, A. G. Tsai, M. Intaglietta, and E. Tsuchida Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1191 - H1199. [Abstract] [Full Text] [PDF]

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