Muir William W, Del Rio Carlos L, Ueyama Yukie, Youngblood Bradley L, George Robert S, Rausch Carl W, Lau Billy S H, Hamlin Robert L
QTest Labs, 6456 Fiesta Drive, Columbus, OH 43235, USA.
New A Innovation Ltd. 17/F, Chevalier Commercial Centre, 8 Wang Hoi Road, Kowloon Bay, Kowloon, Hong Kong.
Crit Care Res Pract. 2014;2014:864237. doi: 10.1155/2014/864237. Epub 2014 Oct 27.
We determined the dose-dependent effects of OC99, a novel, stabilized hemoglobin-based oxygen-carrier, on hemodynamics, systemic and pulmonary artery pressures, surrogates of tissue oxygen debt (arterial lactate 7.2 ± 0.1 mM/L and arterial base excess -17.9 ± 0.5 mM/L), and tissue oxygen tension (tPO2) in a dog model of controlled severe oxygen-debt from hemorrhagic shock. The dose/rate for OC99 was established from a pilot study conducted in six bled dogs. Subsequently twenty-four dogs were randomly assigned to one of four groups (n = 6 per group) and administered: 0.0, 0.065, 0.325, or 0.65 g/kg of OC99 combined with 10 mL/kg lactated Ringers solution administered in conjunction with 20 mL/kg Hextend IV over 60 minutes. The administration of 0.325 g/kg and 0.65 g/kg OC99 produced plasma hemoglobin concentrations of 0.63 ± 0.01 and 1.11 ± 0.02 g/dL, respectively, improved systemic hemodynamics, enhanced tPO2, and restored lactate and base excess values compared to 0.0 and 0.065 g/kg OC99. The administration of 0.65 g/kg OC99 significantly elevated pulmonary artery pressure. Plasma hemoglobin concentrations of OC99 ranging from 0.3 to 1.1 g/dL, in conjunction with colloid based fluid resuscitation, normalized clinical surrogates of tissue oxygen debt, improved tPO2, and avoided clinically relevant increases in pulmonary artery pressure.
我们在失血性休克导致的可控性严重氧债犬模型中,确定了新型稳定化血红蛋白氧载体OC99对血流动力学、体循环和肺动脉压力、组织氧债替代指标(动脉血乳酸7.2±0.1 mM/L和动脉血碱剩余-17.9±0.5 mM/L)以及组织氧张力(tPO2)的剂量依赖性效应。OC99的剂量/速率是根据对6只放血犬进行的初步研究确定的。随后,将24只犬随机分为四组(每组n = 6),并给予:0.0、0.065、0.325或0.65 g/kg的OC99,同时在60分钟内给予10 mL/kg乳酸林格液,并与20 mL/kg Hextend静脉注射液联合使用。与0.0和0.065 g/kg OC99相比,给予0.325 g/kg和0.65 g/kg OC99分别使血浆血红蛋白浓度达到0.63±0.01和1.11±0.02 g/dL,改善了体循环血流动力学,提高了tPO2,并恢复了乳酸和碱剩余值。给予0.65 g/kg OC99显著升高了肺动脉压力。OC99血浆血红蛋白浓度在0.3至1.1 g/dL范围内,结合基于胶体的液体复苏,使组织氧债的临床替代指标正常化,改善了tPO2,并避免了肺动脉压力出现临床相关的升高。