Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles

Hiromi Sakai, Shinji Takeoka, Reto Wettstein, Amy G. Tsai, Marcos Intaglietta, Eishun Tsuchida

    Research output: Contribution to journalArticle

    60 Citations (Scopus)

    Abstract

    A phospholipid vesicle encapsulating hemoglobin (Hb vesicle, HbV) has been developed to provide O2-carrying capacity to plasma expanders. Its ability to restore systemic and microcirculatory conditions after hemorrhagic shock was evaluated in the dorsal skinfold window preparation of conscious hamsters. The HbV was suspended in 8% human serum albumin (HSA) at Hb concentrations of 3.8 g/dl [HbV(3.8)/HSA] and 7.6 g/dl [HbV(7.6)/HSA]. Shock was induced by 50% blood withdrawal, and mean arterial pressure (MAP) at 40 mmHg was maintained for 1 h by the additional blood withdrawal. The hamsters receiving either HbV(3.8)/HSA or HbV(7.6)/HSA suspensions restored MAP to 93 ± 14 and 93 ± 10 mmHg, respectively, similar with those receiving the shed blood (98 ± 13 mmHg), which were significantly higher by comparison with resuscitation with HSA alone (62 ± 12 mmHg). Only the HSA group tended to maintain hyperventilation and negative base excess after the resuscitation. Subcutaneous microvascular blood flow reduced to ∼10-20% of baseline during shock, and reinfusion of shed blood restored blood flow to ∼60-80% of baseline, an effect primarily due to the sustained constriction of small arteries A0 (diameter 143 ± 29 μm). The HbV(3.8)/HSA group had significantly better microvascular blood flow recovery and nonsignificantly better tissue oxygenation than of the HSA group. The recovery of base excess and improved tissue oxygenation appears to be primarily due to the increased oxygen-carrying capacity of HbV fluid resuscitation.

    Original languageEnglish
    JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
    Volume283
    Issue number3 52-3
    Publication statusPublished - 2002

    Fingerprint

    Hemorrhagic Shock
    Resuscitation
    Serum Albumin
    Conservation of Natural Resources
    Cricetinae
    Shock
    Arterial Pressure
    Hyperventilation
    Constriction
    Phospholipids
    Suspensions
    Hemoglobins
    Arteries
    Oxygen

    Keywords

    • Artificial red blood cells
    • Blood substitutes
    • Liposome
    • Microcirculation
    • Microhemodynamics

    ASJC Scopus subject areas

    • Physiology

    Cite this

    Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles. / Sakai, Hiromi; Takeoka, Shinji; Wettstein, Reto; Tsai, Amy G.; Intaglietta, Marcos; Tsuchida, Eishun.

    In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 283, No. 3 52-3, 2002.

    Research output: Contribution to journalArticle

    Sakai, Hiromi ; Takeoka, Shinji ; Wettstein, Reto ; Tsai, Amy G. ; Intaglietta, Marcos ; Tsuchida, Eishun. / Systemic and microvascular responses to hemorrhagic shock and resuscitation with Hb vesicles. In: American Journal of Physiology - Heart and Circulatory Physiology. 2002 ; Vol. 283, No. 3 52-3.
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    abstract = "A phospholipid vesicle encapsulating hemoglobin (Hb vesicle, HbV) has been developed to provide O2-carrying capacity to plasma expanders. Its ability to restore systemic and microcirculatory conditions after hemorrhagic shock was evaluated in the dorsal skinfold window preparation of conscious hamsters. The HbV was suspended in 8{\%} human serum albumin (HSA) at Hb concentrations of 3.8 g/dl [HbV(3.8)/HSA] and 7.6 g/dl [HbV(7.6)/HSA]. Shock was induced by 50{\%} blood withdrawal, and mean arterial pressure (MAP) at 40 mmHg was maintained for 1 h by the additional blood withdrawal. The hamsters receiving either HbV(3.8)/HSA or HbV(7.6)/HSA suspensions restored MAP to 93 ± 14 and 93 ± 10 mmHg, respectively, similar with those receiving the shed blood (98 ± 13 mmHg), which were significantly higher by comparison with resuscitation with HSA alone (62 ± 12 mmHg). Only the HSA group tended to maintain hyperventilation and negative base excess after the resuscitation. Subcutaneous microvascular blood flow reduced to ∼10-20{\%} of baseline during shock, and reinfusion of shed blood restored blood flow to ∼60-80{\%} of baseline, an effect primarily due to the sustained constriction of small arteries A0 (diameter 143 ± 29 μm). The HbV(3.8)/HSA group had significantly better microvascular blood flow recovery and nonsignificantly better tissue oxygenation than of the HSA group. The recovery of base excess and improved tissue oxygenation appears to be primarily due to the increased oxygen-carrying capacity of HbV fluid resuscitation.",
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    AU - Intaglietta, Marcos

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