Abstract | BACKGROUND: STUDY DESIGN AND METHODS: After 55 percent estimated blood volume-controlled hemorrhage by catheter withdrawal, swine (n=48) were resuscitated with HBOC-201 or Hextend (HEX) infused in four doses over 4 hours or not resuscitated (NON). Animals were randomly assigned in two cohorts of 4- or 24-hour simulated delay to hospital arrival (access to blood and saline infusions up to 72 hr). In vitro hematologic monitoring was assessed with complete blood count, hemostasis (thromboelastography [TEG], in vitro bleeding time [PFA]), and coagulation (prothrombin time [PT], thrombin- antithrombin, fibrinogen) indices. RESULTS: Within groups, survival was unaffected by extending delay from 4 to 24 hours. Combined survival was similar for HBOC-201 and HEX but lower for NON animals (93.5, 81.5, and 25 percent, respectively; p<0.01). Blood transfusion requirements were lower with HBOC-201 than HEX. Elevated TEG and PFA parameters in resuscitated animals reflected fluid and blood transfusion regimens. TEG reaction time and PFA were transiently higher with HBOC-201 than with HEX during the early hospital phase. PT was increased in HEX animals. CONCLUSION: In this severe model, survival was equivalent with HBOC-201 and HEX resuscitation. HBOC-201 or HEX allowed delayed hospital arrival to 24 hours without worsening coagulation parameters, but dilutional mild coagulopathy in the hospital phase persisted with HBOC-201 due to blood transfusion avoidance. Low hematocrit suggests that blood administration after HBOC-201 resuscitation could be beneficial to replete blood cellular mass.
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Authors | Francoise Arnaud, Daniel Fasipe, Nora Philbin, Jennifer Rice, W Shannon Flournoy, Stephen Ahlers, Richard McCarron, Daniel Freilich |
Journal | Transfusion
(Transfusion)
Vol. 47
Issue 11
Pg. 2098-109
(Nov 2007)
ISSN: 0041-1132 [Print] United States |
PMID | 17958540
(Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Blood Substitutes
- Hemoglobins
- HBOC 201
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Topics |
- Animals
- Blood Coagulation
- Blood Coagulation Tests
- Blood Substitutes
(therapeutic use)
- Blood Transfusion
- Hematologic Tests
- Hemoglobins
(therapeutic use)
- Hemorrhage
(therapy)
- Resuscitation
(methods)
- Swine
- Time Factors
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