Kasper S M, Walter M, Grüne F, Bischoff A, Erasmi H, Buzello W
Department of Anesthesiology, University of Cologne, Germany.
Anesth Analg. 1996 Nov;83(5):921-7.
We conducted a pilot study to evaluate the effects of HBOC-201, a bovine hemoglobin-based oxygen carrier, on hemodynamics and oxygen transport in patients undergoing preoperative hemodilution for elective abdominal aortic surgery. After induction of anesthesia and isovolemic hemodilution with 1 L of lactated Ringer's solution, 13 patients were randomly assigned to receive, within 30 min, 3 mL/kg of either HBOC-201 or 6% hydroxyethyl starch (HES). Monitored variables included invasive arterial and pulmonary artery pressures, arterial and mixed venous blood gases, and calculations of cardiac index (CI), systemic and pulmonary vascular resistance indices, oxygen delivery index (DO2I), oxygen consumption index (VO2I), and oxygen extraction ratio (O2ER). Thirty minutes after HBOC-201 infusion, mean arterial pressure, systemic vascular resistance index, and CI were 149% (P = 0.028), 169% (P = 0.046), and 75% (P = 0.46) of the preinfusion values, respectively. No significant changes were noticed in heart rate and pulmonary vascular resistance index. DO2I and VO2I, 30 min after the infusion of HBOC-201, were 79% (P = 0.046) and 76% (P = 0.028) of the preinfusion values, respectively, whereas CaO2 and O2ER remained unaffected. We conclude that HBOC-201, at a dose of 3 mL/kg, impairs oxygen delivery because of adverse effects on cardiac output.
我们进行了一项初步研究，以评估基于牛血红蛋白的氧载体HBOC-201对接受择期腹主动脉手术术前血液稀释患者的血流动力学和氧输送的影响。在麻醉诱导并用1升乳酸林格氏液进行等容血液稀释后，13名患者被随机分配在30分钟内接受3 mL/kg的HBOC-201或6%羟乙基淀粉（HES）。监测变量包括有创动脉压和肺动脉压、动脉血和混合静脉血气，以及心指数（CI）、全身和肺血管阻力指数、氧输送指数（DO2I）、氧消耗指数（VO2I）和氧摄取率（O2ER）的计算。输注HBOC-201后30分钟，平均动脉压、全身血管阻力指数和CI分别为输注前值的149%（P = 0.028）、169%（P = 0.046）和75%（P = 0.46）。心率和肺血管阻力指数无显著变化。输注HBOC-201后30分钟，DO2I和VO2I分别为输注前值的79%（P = 0.046）和76%（P = 0.028），而CaO2和O2ER保持不变。我们得出结论，剂量为3 mL/kg的HBOC-201由于对心输出量有不利影响而损害氧输送。
