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*Department of Anesthesiology, Charles R. Drew University of Medicine and Science, King/Drew Medical Center, Los Angeles, California;
Department of Clinical Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles;
Department of Anesthesiology and Toxicology Laboratory, Charles R. Drew University of Medicine and Science, Los Angeles, and
Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Mexico; Departments of
¶Medical Pathology and
#Surgery, University of California-Davis School of Medicine, Davis, California; and
**Department of Clinical Studies, New Bolton Center-School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
Address correspondence and reprint requests to J. S. Jahr, MD, Department of Anesthesiology, UCLA, Box 951778, Los Angeles, CA 90095. Address e-mail to jsjahr{at}mednet.ucla.edu
We measured lead concentrations in three hemoglobin-based oxygen carriers (HBOCs; Oxyglobin®, Hemopure®, and HemolinkTM) and compared them with lead concentrations from blood-bank blood. Oxyhemoglobin dissociation was measured with large concentrations of lead in bovine HBOC, with or without bovine blood, and in bovine blood. Samples of each were prepared by combining one with normal saline (control), the second with small lead concentrations (22 µg/dL), and the third with toxic lead concentrations (70 µg/dL). They were blended in 2 tonometers at oxygen concentrations (2.5%, 5%, 8%, 10%, 21%, and 95%) with 5% CO2 and the remainder nitrogen for 5 min per sample after a 15-min wash-in with each level of oxygen and were measured with co-oximetry. Oxygen saturation was plotted against PO2, fitting fourth-order polynomial nonlinear regression to the data. The lead concentrations of the three HBOCs were 0.51, 0.22, 0.40 µg/dL. There were no clinically important differences of the oxyhemoglobin dissociation curves as a function of lead concentration. The lead concentrations of the three tested HBOCs were small and no larger than the average for blood-bank blood. The presence of increasing concentrations of lead in either concentrated solution of bovine HBOC or a 1:1 mixture of bovine HBOC and native bovine blood does not appear to affect hemoglobin oxygenation in an acute in vitro model of increased lead concentrations.
IMPLICATIONS: Gunshot wounds rapidly increase circulating lead concentrations. Lead concentrations are small in three hemoglobin-based oxygen carriers (HBOCs), and HBOCs and/or bovine blood do not appear to be affected by lead concentrations in terms of immediate oxygen on-loading and off-loading. HBOCs may be useful in patients with gunshot wounds.
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