应用牛无细胞血红蛋白HBOC - 201后增强了中枢器官氧合作用。

Enhanced central organ oxygenation after application of bovine cell-free hemoglobin HBOC-201.

作者信息

Freitag Marc, Standl Thomas G, Gottschalk André, Burmeister Marc A, Rempf Christian, Horn Ernst P, Strate Tim, Schulte Am Esch Jochen

机构信息

Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany.

出版信息

Can J Anaesth. 2005 Nov;52(9):904-14. doi: 10.1007/BF03022050.

DOI:10.1007/BF03022050

PMID:16251554

Abstract

PURPOSE

While the effects of dilutional anemia or isovolemic hemodilution (IHD) on the oxygen extraction and tissue oxygenation in peripheral organs after application of hemoglobin-based oxygen carriers like HBOC-201 have been studied intensively, little is known about tissue oxygenation properties of hemoglobin solutions in central organs like the liver.

METHODS

Twelve Foxhounds were anesthetized and then randomized to either a control group without hemodilution (Group 1) or underwent first step isovolemic hemodilution (pulmonary artery occlusion pressure constant) with Ringer's solution (Group 2) to a hematocrit of 25% with second step infusion of HBOC-201 until a hemoglobin concentration of +0.6 g.dL(-1) was reached. Tissue oxygen tensions (tpO2) were measured in the gastrocnemius muscle using a polarographic needle probe, and in the liver using a flexible polarographic electrode.

RESULTS

While arterial oxygen content and oxygen delivery decreased with hemodilution in Group 2, global liver and muscle oxygen extraction ratio increased after hemodilution and additional application of HBOC-201. Hemodilution and application of HBOC-201 provided augmentation of the mean liver tpO2 (baseline: 48 +/- 9, 20 min: 53 +/- 10, 60 min: 67 +/- 11*, 100 min: 68 +/- 7*; *P < 0.05 vs baseline and Group 1), while oxygen tensions in Group 1 remained unchanged. Oxygen tension in the skeletal muscle increased after hemodilution and additionally after application of HBOC-201 in comparison to baseline and to the control group (P < 0.05).

CONCLUSION

In the present animal model, IHD with Ringer's solution and additional application of HBOC-201 increased oxygen extraction and tpO(2) in the liver and skeletal muscle, in parallel and in comparison with baseline values and a control group.

摘要

目的

虽然对于应用如HBOC - 201等基于血红蛋白的氧载体后，稀释性贫血或等容血液稀释（IHD）对外周器官氧摄取和组织氧合的影响已进行了深入研究，但对于肝脏等中心器官中血红蛋白溶液的组织氧合特性却知之甚少。

方法

12只猎狐犬麻醉后，随机分为未进行血液稀释的对照组（第1组），或先用林格氏液进行第一步等容血液稀释（肺动脉闭塞压恒定）至血细胞比容为25%（第2组），第二步输注HBOC - 201直至血红蛋白浓度达到+0.6 g·dL⁻¹。使用极谱针式探头在腓肠肌中测量组织氧张力（tpO₂），并使用柔性极谱电极在肝脏中测量。

结果

在第2组中，随着血液稀释，动脉血氧含量和氧输送量降低，但血液稀释并额外应用HBOC - 201后，肝脏和肌肉的整体氧摄取率增加。血液稀释和应用HBOC - 201使肝脏平均tpO₂升高（基线：48±9，20分钟：53±10，60分钟：67±11*，100分钟：68±7*；*与基线和第1组相比，P < 0.05），而第1组的氧张力保持不变。与基线和对照组相比，血液稀释后以及额外应用HBOC - 201后，骨骼肌中的氧张力增加（P < 0.05）。