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J Appl Physiol 85: 993-1003, 1998;
8750-7587/98 $5.00
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Vol. 85, Issue 3, 993-1003, September 1998

Vascular resistance and the efficacy of red cell substitutes in a rat hemorrhage model

Robert M. Winslow, Armando Gonzales, Maria L. Gonzales, Michael Magde, Michael McCarthy, Ronald J. Rohlfs, and Kim D. Vandegriff

Department of Medicine, School of Medicine, University of California, San Diego, and Department of Veterans Affairs Medical Center, San Diego, California 92161

We have compared polyethylene glycol-modified bovine hemoglobin (PEG-Hb; high O2 affinity, high viscosity, high oncotic pressure) and human hemoglobin cross-linked between the alpha -chains (alpha alpha -Hb; low O2 affinity, low viscosity, low oncotic pressure) with a non-O2-carrying plasma expander (pentastarch, high viscosity and oncotic pressure) after a 50% (by volume) exchange transfusion followed by a severe (60% of blood volume) hemorrhage. Mean arterial pressure and systemic vascular resistance rose significantly in the alpha alpha -Hb but not in the PEG-Hb animals. Two-hour survival was greater in the PEG-Hb animals (93%) than in control (35%), pentastarch (8%), or alpha alpha -Hb (6%) animals. In the PEG-Hb animals, there was no disturbance of acid-base balance, significantly less accumulation of lactic acid, and higher cardiac output than in the other groups. The data suggest that the rise in vascular resistance that follows alpha alpha -Hb exchange transfusion offsets the additional O2 transport provided by the cell-free hemoglobin. When resistance does not rise, as with PEG-Hb, even relatively small amounts of cell-free hemoglobin appear to be a very effective blood replacement.

hemodilution; hemorrhage; blood substitutes; hemoglobin; alpha alpha -hemoglobin


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