Abstract
Background: Hemoglobin-based blood substitutes appear poised to deliver the promise
of a universally compatible, disease-free alternative to banked blood. However, vasoconstriction
following administration of tetrameric hemoglobins has been problematic, likely because
of nitric oxide binding. Polymerized hemoglobin is effectively excluded from the abluminal
space because of its size, and is thus less likely to perturb vasorelaxation. We therefore
hypothesized that hemodynamic responses would be no different in injured patients
receiving polymerized hemoglobin versus banked blood.
Methods: Injured patients requiring urgent transfusion were randomized to receive
either polymerized hemoglobin or banked blood. Systemic arterial pressure, pulmonary
arterial pressure, cardiac index, pulmonary capillary wedge pressure, systemic vascular
resistance, and pulmonary vascular resistance were measured serially.
Results: There was no difference in any of the measured hemodynamic parameters between
patients resuscitated with polymerized hemoglobin versus blood.
Conclusions: Polymerized hemoglobin given in large doses to injured patients lacks
the vasoconstrictive effects reported in the use of other hemoglobin-based blood substitutes.
This supports the continued investigation of polymerized hemoglobin in injured patients
requiring urgent transfusion.
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Article info
Footnotes
☆This work was supported in part by National Institutes of Health Grants P50GM49222 and T32GM08315.
Identification
Copyright
© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
