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1 Department of Hematology and Physiology, School of Pharmacy, University Henri Poincaré-Nancy 1, 54001 Nancy Cedex, France; and 2 Laboratory of Plasma Derivatives, Center for Biologics Evaluation and Research, US Food and Drug Administration, Bethesda, Maryland 20892
Hb-based
O2-carrying solutions (HbOCs) have been developed as red
blood cell substitutes for use in patients undergoing hemodilution. Variously modified Hb with diverse solution properties have been shown
to produce variable hemodynamic responses. We examined, through
pulsed-Doppler velocimetry, the systemic and renal hemodynamic effects
of dextran-benzene-tetracarboxylate-conjugated (Hb-Dex-BTC), bis(3,5-dibromosalicyl)fumarate cross-linked (
-Hb), and
o-raffinose-polymerized (o-raffinose-Hb) Hb perfused in
rabbits after moderate hemodilution (30% hematocrit), and we compared
the effects of these Hb solutions with the effects elicited by plasma
volume expanders. In addition, vascular hindrance (resistance/blood
viscosity at 128.5 s
1) was calculated to
determine whether a moderate decrease in the viscosity of blood mixed
with HbOCs may impair vasoconstriction as a result of autoregulation
after infusion of cell-free Hb. No changes were observed in renal
hemodynamics after hemodilution with reference or Hb solutions.
Increase in blood pressure and vascular resistance was found with
Hb-Dex-BTC and 
-Hb (for 180 min) and, to a lesser extent, with
o-raffinose-Hb (for 120 min). Furthermore, Hb-Dex-BTC (high
viscosity) and o-raffinose-Hb (medium viscosity) induced
comparable increases in vascular hindrance (from 0.091 to 0.159 and
from 0.092 to 0.162 cm
1, respectively)
but far less than that produced by 
-Hb (low viscosity, from 0.092 to 0.200 cm
1). These results suggest
that maintaining the viscosity of blood by infusing solutions with high
viscosity makes it possible to limit vasoconstriction due to
autoregulation mechanisms and mainly caused by hemodilution per se.
blood substitutes; vascular resistance; blood flow; vascular hindrance; viscosity; exchange transfusion
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