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Transcript of artif cells13256590
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ARTIFICIAL CELLS, BLOOD SUBSTITUTES, AND BIOTECHNOLOGY
Vol. 32, No. 2, pp. 189207, 2004
Blood Substitute Resuscitation as a Treatment
Modality for Moderate Hypovolemia
Anthony T. W. Cheung,1,*Bernd Driessen,3 Jonathan S. Jahr,4
Patricia L. Duong,1 Sahana Ramanujam,1 Peter C. Y. Chen,5
and Robert A. Gunther2
1Department of Medical Pathology and2Department of Surgery, University of California, Davis School of
Medicine, Sacramento, California, USA3Department of Clinical Studies, University of Pennsylvania School
of Veterinary Medicine, Kennett Square, Pennsylvania, USA4Department of Anesthesiology, University of California,
Los Angeles David Geffen School of Medicine, Los Angeles,
California, and Department of Anesthesiology, Charles Drew
University of Medicine and Science,
Los Angeles, California, USA5Department of Bioengineering, University of California, San Diego,
La Jolla, California, USA
*Correspondence: Anthony T. W. Cheung, Professor of Clinical Pathology,
Department of Medical Pathology, UC Davis School of Medicine, Research-III
Building (Suite 3400), UC Davis Medical Center, 4645 Second Ave., Sacramento,
CA 95817, USA; Fax: (916) 734-2698; E-mail: [email protected].
189
DOI: 10.1081/BIO-120037827 1073-1199 (Print); 1532-4184 (Online)
Copyright &2004 by Marcel Dekker, Inc. www.dekker.com
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ORDER REPRINTS
ABSTRACT
Blood substitute resuscitation as a treatment modality for mode-
rate hypovolemia (40% blood loss) in a canine model has been
evaluated using Oxyglobin (Biopure Hemoglobin Glutamer-200/
Bovine; a hemoglobin-based oxygen-carrier) and Hespan (6%
hetastarch; a nonoxygen-carrier) as resuscitants. Autologous (shed)
blood served as control. Nine dogs were studiedafter splenectomy,
each dog was hemorrhaged (3236 mL/kg; MAP 50 mmHg) and
randomly assigned to the three resuscitation groups. Microvascular,
systemic function and oxygenation characteristics were monitored
and/or measured simultaneously in prehemorrhagic (baseline),
posthemorrhagic and postresuscitation phases for correlation
real-time microvascular changes in the bulbar conjunctiva were
noninvasively measured via computer-assisted intravital microscopy
and systemic function and oxygenation changes were monitored and/
or measured via instrumentation and devices incorporated into our
bioengineering station in an operating room setting. Blood chemistry
was also studied for relevant measurements. Prehemorrhagic
microvascular characteristics were similar in all animals (venular
diameter 41 12mm, A:V ratio 1:2, red-cell velocity 0.5
0.3 mm/s). All animals also showed similar prehemorrhagic systemic
function and oxygenation measurements comparable to a previous
study and were consistent with normal measurements in dogs. At
the completion of hemorrhaging to achieve moderate hypovo-
lemia (40% blood loss with MAP at 50 mmHg), all nine animals
showed similar significant (P