Moores W Y, White F C, Bloor C, Greenburg A G, Mack R, Willford D C
Prog Clin Biol Res. 1983;122:89-99.
Two chronic animal models and one acute animal model were used to evaluate exchange transfusion with stroma-free hemoglobin solutions. A direct comparison was made between stroma-free hemoglobin solutions having differing oxygen offloading characteristics as well as a colloid solution consisting of 7% bovine albumin. These studies involved a partial exchange involving approximately 50% of the animal's blood volume to simulate a clinically more appropriate partial blood replacement situation. We noted a consistent increase in the arterial oxygen content of animals exchanged with the stroma-free hemoglobin solutions and some modest improvement in oxygen dynamics. Our studies examining myocardial contractility, especially those carried out in the right heart bypass swine preparation failed to substantiate any difference between an exchange with albumin or stroma-free hemoglobin solutions. The conscious animal models examined both at rest and at exercise demonstrated marked differences in exercise response. Animals exchanged transfused with stroma-free hemoglobin solutions often had an almost normal exercise response while those animals exchanged with non-oxygen carrying albumin solution frequently failed to exercise on a treadmill. Blood flow measurements using radiolabeled microspheres were performed in chronically instrumented swine. These animals had a normal variation in organ blood flow during exercise which was noted both during the control period as well as following exchange with stroma-free hemoglobin solutions. Animals exchanged transfused with albumin had a marked derangement in organ blood flow apparently reflecting the decreased oxygen availability. Results from these three studies substantiate a significant benefit to animals undergoing a 50% exchange when that exchange is done with an oxygen carrying solution such as stroma-free hemoglobin solutions as opposed to a non-oxygen carrying but oncotically active solution such as albumin solution. These studies seem to offer encouragement to the continued investigation and ultimate clinical utilization of hemoglobin solutions as an appropriate blood substitute.
使用两种慢性动物模型和一种急性动物模型来评估无基质血红蛋白溶液的换血疗法。对具有不同氧卸载特性的无基质血红蛋白溶液以及由7%牛白蛋白组成的胶体溶液进行了直接比较。这些研究涉及约50%动物血容量的部分换血，以模拟临床上更合适的部分血液置换情况。我们注意到，用无基质血红蛋白溶液进行换血的动物动脉氧含量持续增加，并且氧动力学有一定程度的改善。我们对心肌收缩力的研究，特别是在右心旁路猪制备中进行的研究，未能证实白蛋白或无基质血红蛋白溶液换血之间存在任何差异。对清醒动物模型在静息和运动状态下的检查显示运动反应存在显著差异。用无基质血红蛋白溶液进行换血的动物在运动时通常有几乎正常的运动反应，而用不携带氧的白蛋白溶液进行换血的动物在跑步机上经常无法运动。在长期植入仪器的猪中使用放射性标记微球进行血流测量。这些动物在运动期间器官血流有正常变化，在对照期以及用无基质血红蛋白溶液换血后均有观察到。用白蛋白进行换血的动物器官血流明显紊乱，这显然反映了氧供应减少。这三项研究的结果证实，当用携带氧的溶液（如无基质血红蛋白溶液）而不是不携带氧但具有胶体活性的溶液（如白蛋白溶液）进行50%的换血时，对接受换血的动物有显著益处。这些研究似乎为继续研究血红蛋白溶液并最终将其临床应用作为合适的血液替代品提供了鼓励。
