Influence of heme-based solutions on stress protein expression and organ failure after hemorrhagic shock.
This experimental study investigated the effects of oxygen-carrying and non-oxygen-carrying heme solutions on the induction of the protective enzyme heme oxygenase (HO)-1 in a rat model of hemorrhagic shock (fixed pressure). (HO)-1 induction appears to be of particular importance for hepatocellular integrity and function after ischemia and reperfusion. The authors demonstrated that pre-treatment with the […]
Perflubron emulsion in prolonged hemorrhagic shock: influence on hepatocellular energy metabolism and oxygen-dependent gene expression.
This experimental study, using quite sophisticated methods, demonstrates that a perfluorocarbon emulsion together with a high FiO2 is able to improve oxygen availability to the liver as compared to stored whole blood or colloids during prolonged hemorrhagic shock. This is another contribution to the increased evidence that, like hemoglobin solutions, perfluorocarbon solutions are not blood […]
Diaspirin-crosslinked hemoglobin reduces blood transfusion in noncardiac surgery: a multicenter, randomized, controlled, double-blinded trial.
The authors investigated, in a multicenter, double-blind, randomized trial, whether diaspirin-crosslinked hemoglobin (DCLHb) could reduce the use of allogeneic blood transfusions. This is a very interesting study for several reasons. First, the study is one of the very few in the area of transfusion medicine that was able to implement and maintain a double-blind study […]
This article reviews the current status of the hemoglobin-based oxygen carriers (HBOC) presently under development. It also introduces the idea that all the HBOCs are not expected to be clinically equivalent so that each solution will locate its clinical niche as the characteristics of the different products are better understood. – Philippe Van der Linden […]
Small-volume resuscitation with HBOC-201: effects on cardiovascular parameters and brain tissue oxygen tension in an out-of-hospital model of hemorrhage in swine.
This experimental observational study reports that, in anesthetized pigs undergoing hemorrhage, small volume resuscitation (6 mL/kg) of a bovine hemoglobin based oxygen carrier can restore mean arterial pressure and cardiac output while improving brain oxygen tension. – Philippe Van der Linden This is a second article on the effect of HBOC-201 for the acute treatment […]
This review article discusses the past, present and future of oxygen carriers, not only as “blood substitutes” but also, more importantly, as “oxygen therapeutics.” – Philippe Van der Linden
Effects of ultra-purified polymerized bovine hemoglobin on local tissue oxygen tension in striated skin muscle – An efficacy study in the hamster.
This is another study on the potential benefits of an oxygen carrier (ultrapurified polymerized bovine hemoglobin solution) on tissue perfusion after hypervolemic infusion or exchange transfusion of 50% of blood volume in a hamster model. The authors have shown that the infusion of the hemoglobin solution actually decreases (slightly) mean tissue pO2 but homogenizes local […]
Oxygen transport dynamics of acellular hemoglobin solutions in an isovolemic hemodilution model in swine.
It does not come as a surprise that hemoglobin solutions improve oxygen delivery and consumption in severely anemic swine. However, changes in P-50 do not appear to modify oxygen dynamics over a large range of hematocrits. This is quite a surprise, considering the efforts taken by the manufacturers to produce a solution that possess the […]
Selective aortic arch perfusion with hemoglobin-based oxygen carrier-201 for resuscitation from exsanguinating cardiac arrest in swine.
The important message in this case is that a hemoglobin-based oxygen carrier was able to restore viable cardiovascular function after exsanguinating cardiac arrest in a swine model of liver injury with profound hemorrhagic shock. Nonetheless, the reader is left with many questions. What effect(s) of the hemoglobin solution was responsible for the favorable outcome observed―a […]
Hypotensive resuscitation using a polymerized bovine hemoglobin-based oxygen-carrying solution (HBOC-201) leads to reversal of anaerobic metabolism.
Interesting article evaluating the place of a hemoglobin-based oxygen-carrying solution in the resuscitation of severe hemorrhagic shock. – P. Van der Linden.