Bone H G, Fischer S R, Schenarts P J, McGuire R, Traber L D, Traber D L
Department of Anesthesiology and Intensive Care Medicine, Westfälische-Wilhelms-Universität, Münster, Germany.
Shock. 1998 Jul;10(1):69-76. doi: 10.1097/00024382-199807000-00012.
Cell-free hemoglobin solutions can scavenge nitric oxide and therefore increase mean arterial pressure (MAP). The present study investigated the effects of a continuous low-dose infusion of modified hemoglobin during ovine hyperdynamic sepsis. 13 sheep received a continuous infusion of live Pseudomonas aeruginosa bacteria for 48 h. Animals that survived the first 24 h of sepsis (n=12) were randomly assigned either to a treatment group that received 20 mg x kg(-1) x h(-1) pyridoxalated hemoglobin polyoxyethylene conjugate (PHP) for 20 h or to a control group that received the same volume of the vehicle for 20 h. MAP increased in the treatment group during 4 h of PHP infusion 12.7+/-1.7 mmHg (p < .05) and after 20 h of PHP infusion MAP was still 12.4+/-2.1 mmHg above the MAP before starting PHP (p < .05). MAP in the control group did not change significantly from 24 h to 48 h of sepsis. No differences in regional blood flow were seen between groups. Bacterial counts in the spleen and kidney were lower in the treatment group than in the control group. Continuous low-dose infusion of PHP can normalize systemic vascular resistance and MAP for long periods without deterioration of regional blood flow or bacterial clearance.
无细胞血红蛋白溶液可清除一氧化氮，因此会增加平均动脉压（MAP）。本研究调查了在绵羊高动力性脓毒症期间持续低剂量输注改良血红蛋白的效果。13只绵羊接受了48小时的活铜绿假单胞菌连续输注。在脓毒症最初24小时存活的动物（n = 12）被随机分为治疗组或对照组，治疗组接受20 mg·kg⁻¹·h⁻¹的吡哆醛化血红蛋白聚氧乙烯共轭物（PHP）输注20小时，对照组接受相同体积的赋形剂输注20小时。在PHP输注4小时期间，治疗组的MAP升高了12.7±1.7 mmHg（p < 0.05），在PHP输注20小时后，MAP仍比开始输注PHP前的MAP高12.4±2.1 mmHg（p < 0.05）。对照组的MAP在脓毒症24小时至48小时期间无显著变化。两组之间区域血流未见差异。治疗组脾脏和肾脏中的细菌计数低于对照组。持续低剂量输注PHP可长期使全身血管阻力和MAP恢复正常，而不会使区域血流或细菌清除恶化。
