Resuscitation from hemorrhagic shock with MalPEG-albumin: comparison with MalPEG-hemoglobin

Our aim was to determine the efficacy of polyethylene glycol-conjugated human albumin (MalPEG-Alb) in restoring circulatory volume after 1 h of hemorrhagic shock. Experiments were performed in the awake condition in the hamster skin fold preparation. Microhemodynamic parameters and tissue Po2 were a...

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Published in:Shock (Augusta, Ga.) Ga.), 2004-10, Vol.22 (4), p.351-357
Main Authors: Wettstein, Reto, Cabrales, Pedro, Erni, Dominique, Tsai, Amy G, Winslow, Robert M, Intaglietta, Marcos
Format: Article
Language:English
Subjects:
Animals
Capillaries - physiology
Cricetinae
Hemoglobins - pharmacology
Oxygen - blood
Oxygen Consumption - drug effects
Oxygen Consumption - physiology
Partial Pressure
Plasma Substitutes - therapeutic use
Polyethylene Glycols - pharmacology
Polyethylene Glycols - therapeutic use
Resuscitation - methods
Serum Albumin - pharmacology
Shock, Hemorrhagic - metabolism
Shock, Hemorrhagic - therapy
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Summary:Our aim was to determine the efficacy of polyethylene glycol-conjugated human albumin (MalPEG-Alb) in restoring circulatory volume after 1 h of hemorrhagic shock. Experiments were performed in the awake condition in the hamster skin fold preparation. Microhemodynamic parameters and tissue Po2 were assessed with intravital microscopy and the use of the phosphorescence quenching technique. One hour after shock induction by withdrawal of 50% of the blood volume, animals were resuscitated with MalPEG-Alb (n = 6). Systemic and microhemodynamic parameters following resuscitation were identical to those obtained with the same protocol using MalPEG-Hb (1). However, parameters related to microvascular oxygen distribution were significantly lower in the MalPEG-Alb group compared with the previous data from the MalPEG-Hb group in that tissue oxygen partial pressure was 5 +/- 2 mmHg (vs. 8 +/- 3 mmHg, P < 0.05), oxygen delivery was reduced to 60 +/- 27% (P < 0.05), and oxygen consumption was reduced to 69 +/- 28% (P < 0.05). Both molecules were matched in composition (4.2 g/dL) and surface chemistry. MalPEG-Alb colloid osmotic pressure was 37 mmHg (vs. 49 mmHg for MalPEG-Hb), and viscosity was 2.7 cP (vs. 2.5 cP for MalPEG-Hb). The present results show that both solutions are efficacious plasma expanders and that the hemoglobin-based solution provides improved oxygen distribution and tissue Po2 in the hamster chamber model.
ISSN:1073-2322
DOI:10.1097/01.shk.0000135253.14076.d9