– Philippe Van der Linden
The authors investigated the effect of no fluid resuscitation, resuscitation with hetastarch (HES) or resuscitation with the hemoglobin based oxygen carrier HBOC-201 in a swine model of severe (not to say extreme) hemorrhagic shock. The model was intended to reproduce severe bleeding associated with liver injury and exsanguination leading to cardiac arrest during transfer from the accident scene to the hospital. All animals resuscitated with no fluid or with HES died when the hematocrit dropped below 5%, attesting to the severity of the injury. All but one of the animals treated with HBOC-201 survived with good functional recovery. The authors documented an increase in mean arterial pressure, systemic vascular resistance and mean pulmonary artery pressure, contrary to what has been observed in clinical trials, possibly because of the volumes infused and of the rate of infusion. Nonetheless, one cannot argue with success and this experiment clearly documents, for once, a true potential benefit on survival in cases where bleeding is extreme.
– Jean-Franois Hardy