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Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. Ppublish 19 citations

PubMed: 32097242 DOI: 10.1097/SHK.0000000000001530

Resuscitation From Hemorrhagic Shock With Fresh and Stored Blood and Polymerized Hemoglobin.

Shock 54(4):464-473

Authors: Alexander T Williams, Alfredo Lucas, Cynthia R Muller, Carlos Munoz, Crystal Bolden-Rush, Andre F Palmer, Pedro Cabrales

Affiliations

  • Department of Bioengineering, University of California San Diego, La Jolla, California.
  • William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio.

Abstract

BACKGROUND

Hemoglobin (Hb)-based oxygen carriers (HBOCs) have been proposed as alternatives to blood for decades. Previous studies demonstrated that large molecular diameter HBOCs based on polymerized bovine Hb (PolybHb) attenuate Hb side-effects and toxicity. The objective of this study was to test the safety and efficacy of tense state PolybHb after long-term storage.

METHODS AND RESULTS

PolybHb was subjected to diafiltration to remove low molecular weight (< 500 kDa) species and stored for 2 years. PolybHb was studied in parallel with blood, collected from rats and stored leukodepleted under blood bank conditions for 3 weeks. Rats were hemorrhaged and resuscitated to 90% of the blood pressure before the hemorrhage with fresh blood, stored blood, fresh PolybHb, or 2-year-stored PolybHb. Hemorrhagic shock impaired oxygen delivery and cardiac function. Resuscitation restored blood pressure and cardiac function, but stored blood required a significantly larger transfusion volume to recover from shock compared with fresh blood and PolybHb (fresh and stored). Stored blood transfusion elevated markers of organ damage compared with all other groups.

CONCLUSIONS

These studies indicate that large molecular diameter PolybHb is as efficacious as fresh blood in restoring cardiac function and confirm the lack of degradation of PolybHb's safety or efficacy during long-term storage.

MeSH

Shock, Hemorrhagic, Hemorrhage, Safety, Resuscitation, Blood Pressure, Hemoglobins

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