Objectives: To investigate the effects of small-volume resuscitation with a hemoglobin based oxygen carrier on brain tissue oxygen tension (PbrO2) in hemorrhaged swine.
Methods: Clark-type electrodes were inserted into the brain tissue of 6 swine to measure PbrO2 directly. Swine were hemorrhaged to a MAP of 40 mm Hg for 20 minutes. Resuscitation was performed with a bolus infusion of HBOC-201 (6 cc/kg; Biopure Corp.) and high-flow oxygen (100%). Swine were observed for an additional 2 hours.
Results: PbrO2 prior to hemorrhage was 48.7 +/- 4.7 mm Hg with 100% inspired oxygen. PbrO2 rapidly declined to 7.6 +/- 5.3 mm Hg in response to hemorrhage. Small-volume resuscitation with HBOC-201 and high-flow oxygen resulted in a significant increase (p < 0.001) in PbrO2 to 44.6 +/- 8.1 mm Hg. MAP was also significantly increased to 84% of baseline. These elevations were sustained during the observation period.
Conclusions: Resuscitation with HBOC-201 can restore and sustain cerebral oxygenation and MAP. These results suggest that a small-volume bolus of HBOC-201 may provide adequate oxygen and pressure support during the initial management of hemorrhage.