We have measured plasma volume expansion (Evans blue and hematocrit changes) and hemodynamic responses in conscious hemorrhaged and normovolemic splenectomized sheep after a 30-min infusion of either 20 ml/kg of diaspirin cross-linked hemoglobin (DCLHb), 20 ml/kg of human albumin (Alb), or 60 ml/kg of a solution of Ringer lactate (RL). All regimens expanded blood volume and increased blood pressure and cardiac output after hemorrhage. However, only 15 ± 3% of the infused volume of RL was evident as intravascular expansion 10-min postinfusion, compared with 67 ± 16% and 139 ± 139% for Alb and DCLHb, respectively. DCLHb infusions were associated with higher blood pressures and lower cardiac outputs compared with RL and Alb infusions, but the increased oxygen content of blood with DCLHb resulted in systemic delivery of oxygen similar to that of the other infusions. These differences in hemodynamics and vascular volume continued for 6 h, and at 24 h vascular volume and all hemodynamics were similar in all three groups. The better volume expansion with DCLHb may be due to greater mobilization of endogenous interstitial protein or reduced transcapillary loss as total intravascular endogenous plasma protein increased after infusion of DCLHb, whereas there was an apparent loss of endogenous intravascular protein after infusions of Alb and RL. Vasoconstriction by DCLHb is one mechanism that could lower blood-to-tissue transport of fluid and protein. In addition to its oxygen-carrying capacity and vasoactivity, DCLHb is associated with volume expansion properties out of proportion to its colloid osmotic pressure.

oxygen delivery; hemorrhage; resuscitation; shock

This article has been cited by other articles:

				D. Drobin, B. T. Kjellstrom, E. Malm, A. Malavalli, J. Lohman, K. D. Vandegriff, M. A. Young, and R. M. Winslow Hemodynamic response and oxygen transport in pigs resuscitated with maleimide-polyethylene glycol-modified hemoglobin (MP4) J Appl Physiol, May 1, 2004; 96(5): 1843 - 1853. [Abstract] [Full Text] [PDF]

				L. A. Vane, J. S. Funston, R. Kirschner, D. Harper, D. J. Deyo, D. L. Traber, L. L. Traber, and G. C. Kramer Comparison of transfusion with DCLHb or pRBCs for treatment of intraoperative anemia in sheep J Appl Physiol, January 1, 2002; 92(1): 343 - 353. [Abstract] [Full Text] [PDF]

				M. S. S. Chow, C. Fan, H. Tran, H. Zhao, and L. Zhou Effects of Diaspirin Cross-Linked Hemoglobin (DCLHb) during and Post-CPR in Swine J. Pharmacol. Exp. Ther., April 1, 2001; 297(1): 224 - 229. [Abstract] [Full Text]

				J. S. Jahr, F. Lurie, S. Xi, M. Golkaryeh, O. Kuznetsova, R. Kullar, and B. Driessen A Novel Approach to Measuring Circulating Blood Volume: The Use of a Hemoglobin-Based Oxygen Carrier in a Rabbit Model Anesth. Analg., March 1, 2001; 92(3): 609 - 614. [Abstract] [Full Text] [PDF]

				R. Y. Inoue, J. A. R. Gontijo, and K. G. Franchini Hemodilution mediates hemodynamic changes during acute expansion in unanesthetized rats Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2000; 279(6): R2243 - R2251. [Abstract] [Full Text] [PDF]