铅会干扰基于血红蛋白的氧载体（HBOC）的功能吗？一项关于三种已获批准或经过测试的HBOC中铅浓度以及不同铅浓度下HBOC和/或牛血的氧合血红蛋白解离的初步研究。

Does lead interfere with hemoglobin-based oxygen carrier (HBOC) function? A pilot study of lead concentrations in three approved or tested HBOCs and oxyhemoglobin dissociation with HBOCs and/or bovine blood with varying lead concentrations.

作者信息

Khan Ahsanul K, Jahr Jonathan S, Nesargi Susmita, Rothenberg Stephen J, Tang Zuping, Cheung Anthony, Gunther Robert A, Kost Gerald J, Driessen Bernd

机构信息

*Department of Anesthesiology, Charles R. Drew University of Medicine and Science, King/Drew Medical Center, Los Angeles, California; †Department of Clinical Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles; ‡Department of Anesthesiology and Toxicology Laboratory, Charles R. Drew University of Medicine and Science, Los Angeles, and §Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Mexico; Departments of ¶Medical Pathology and #Surgery, University of California-Davis School of Medicine, Davis, California; and **Department of Clinical Studies, New Bolton Center-School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania.

出版信息

Anesth Analg. 2003 Jun;96(6):1813-1820. doi: 10.1213/01.ANE.0000062517.13989.B5.

DOI:10.1213/01.ANE.0000062517.13989.B5

PMID:12761018

Abstract

UNLABELLED

We measured lead concentrations in three hemoglobin-based oxygen carriers (HBOCs; Oxyglobin, Hemopure, and Hemolink) and compared them with lead concentrations from blood-bank blood. Oxyhemoglobin dissociation was measured with large concentrations of lead in bovine HBOC, with or without bovine blood, and in bovine blood. Samples of each were prepared by combining one with normal saline (control), the second with small lead concentrations (22 micro g/dL), and the third with toxic lead concentrations (70 micro g/dL). They were blended in 2 tonometers at oxygen concentrations (2.5%, 5%, 8%, 10%, 21%, and 95%) with 5% CO(2) and the remainder nitrogen for 5 min per sample after a 15-min wash-in with each level of oxygen and were measured with co-oximetry. Oxygen saturation was plotted against PO(2), fitting fourth-order polynomial nonlinear regression to the data. The lead concentrations of the three HBOCs were 0.51, 0.22, 0.40 micro g/dL. There were no clinically important differences of the oxyhemoglobin dissociation curves as a function of lead concentration. The lead concentrations of the three tested HBOCs were small and no larger than the average for blood-bank blood. The presence of increasing concentrations of lead in either concentrated solution of bovine HBOC or a 1:1 mixture of bovine HBOC and native bovine blood does not appear to affect hemoglobin oxygenation in an acute in vitro model of increased lead concentrations.

IMPLICATIONS

Gunshot wounds rapidly increase circulating lead concentrations. Lead concentrations are small in three hemoglobin-based oxygen carriers (HBOCs), and HBOCs and/or bovine blood do not appear to be affected by lead concentrations in terms of immediate oxygen on-loading and off-loading. HBOCs may be useful in patients with gunshot wounds.

摘要

未标注

我们测量了三种基于血红蛋白的氧载体（HBOCs；氧合球蛋白、血红蛋白替代品和血联素）中的铅浓度，并将其与血库血液中的铅浓度进行比较。在含有或不含牛血的牛HBOC以及牛血中，用高浓度铅测量氧合血红蛋白解离情况。每种样品均制备三份，一份与生理盐水混合（对照），第二份与低铅浓度（22μg/dL）混合，第三份与有毒铅浓度（70μg/dL）混合。将它们在两个氧合仪中，于氧浓度（2.5%、5%、8%、10%、21%和95%）、5%二氧化碳以及其余为氮气的条件下混合，在每个氧水平进行15分钟的预充氧后，每个样品再混合5分钟，然后用共血氧测定法进行测量。将氧饱和度与PO₂作图，对数据拟合四阶多项式非线性回归。三种HBOC的铅浓度分别为0.51、0.22、0.40μg/dL。氧合血红蛋白解离曲线作为铅浓度的函数，没有临床重要差异。三种测试的HBOC的铅浓度较低，不高于血库血液的平均浓度。在牛HBOC浓缩溶液或牛HBOC与天然牛血1:1混合物中，铅浓度增加似乎不会在铅浓度增加的急性体外模型中影响血红蛋白的氧合作用。