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1 Department of Orthopedic, Plastic and Hand Surgery, Inselspital University Hospital, Berne, Switzerland
2 Advanced Research Institute for Science and Engineering, Waseda University, Tokyo, Japan
* To whom correspondence should be addressed. E-mail: dominique.erni{at}insel.ch.
The aim of this study was to test the influence of oxygen affinity of Hb vesicles (HbVs) and level of blood exchange on the oxygenation in collateralized, ischemic and hypoxic hamster flap tissue during normovolemic hemodilution. Microhemodynamics were investigated with intravital microscopy. Partial tissue oxygen tension was measured with Clark-type microprobes. HbVs with P50 of 15 mmHg (HbV15) and 30 mmHg (HbV30) were suspended in 6% dextran 70 (Dx70). The Hb concentration of the solutions was 7.5 g/dl. A stepwise replacement of 15%, 30% and 50% of total blood volume was performed, which resulted in a gradual decrease in total Hb concentration. In the ischemic tissue, hemodilution led to an increase in microvascular blood flow to maximally 141% to 166% of baseline in all groups (median, P<0.01 vs. baseline, NS between groups). Oxygen tension was transiently raised to 121 ±17% after the 30% blood exchange with Dx70 (P < 0.05), whereas it was increased after each step of hemodilution with HbV15-Dx70 and HbV30-Dx70, reaching 217 ±67% (P < 0.01) and 164±33% (P < 0.01 vs. baseline and other groups), respectively, after the 50% blood exchange. We conclude that despite a decrease in total Hb concentration, the oxygenation in the ischemic, hypoxic tissue could be improved with increasing blood exchange with HbV solutions. Furthermore, better oxygenation was obtained with the left-shifted HbV.
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