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ARTIFICIAL CELLS, BLOOD SUBSTITUTES, AND BIOTECHNOLOGY

Vol. 32, No. 2, pp. 189207, 2004

Blood Substitute Resuscitation as a Treatment

Modality for Moderate Hypovolemia

Anthony T. W. Cheung,1,*Bernd Driessen,3 Jonathan S. Jahr,4

Patricia L. Duong,1 Sahana Ramanujam,1 Peter C. Y. Chen,5

and Robert A. Gunther2

1Department of Medical Pathology and2Department of Surgery, University of California, Davis School of

Medicine, Sacramento, California, USA3Department of Clinical Studies, University of Pennsylvania School

of Veterinary Medicine, Kennett Square, Pennsylvania, USA4Department of Anesthesiology, University of California,

Los Angeles David Geffen School of Medicine, Los Angeles,

California, and Department of Anesthesiology, Charles Drew

University of Medicine and Science,

Los Angeles, California, USA5Department of Bioengineering, University of California, San Diego,

La Jolla, California, USA

*Correspondence: Anthony T. W. Cheung, Professor of Clinical Pathology,

Department of Medical Pathology, UC Davis School of Medicine, Research-III

Building (Suite 3400), UC Davis Medical Center, 4645 Second Ave., Sacramento,

CA 95817, USA; Fax: (916) 734-2698; E-mail: atcheung@ucdavis.edu.

189

DOI: 10.1081/BIO-120037827 1073-1199 (Print); 1532-4184 (Online)

Copyright &2004 by Marcel Dekker, Inc. www.dekker.com

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ABSTRACT

Blood substitute resuscitation as a treatment modality for mode-

rate hypovolemia (40% blood loss) in a canine model has been

evaluated using Oxyglobin (Biopure Hemoglobin Glutamer-200/

Bovine; a hemoglobin-based oxygen-carrier) and Hespan (6%

hetastarch; a nonoxygen-carrier) as resuscitants. Autologous (shed)

blood served as control. Nine dogs were studiedafter splenectomy,

each dog was hemorrhaged (3236 mL/kg; MAP 50 mmHg) and

randomly assigned to the three resuscitation groups. Microvascular,

systemic function and oxygenation characteristics were monitored

and/or measured simultaneously in prehemorrhagic (baseline),

posthemorrhagic and postresuscitation phases for correlation

real-time microvascular changes in the bulbar conjunctiva were

noninvasively measured via computer-assisted intravital microscopy

and systemic function and oxygenation changes were monitored and/

or measured via instrumentation and devices incorporated into our

bioengineering station in an operating room setting. Blood chemistry

was also studied for relevant measurements. Prehemorrhagic

microvascular characteristics were similar in all animals (venular

diameter 41 12mm, A:V ratio 1:2, red-cell velocity 0.5

0.3 mm/s). All animals also showed similar prehemorrhagic systemic

function and oxygenation measurements comparable to a previous

study and were consistent with normal measurements in dogs. At

the completion of hemorrhaging to achieve moderate hypovo-

lemia (40% blood loss with MAP at 50 mmHg), all nine animals

showed similar significant (P