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Critical Care

Open Access

Microvascular gut oxygenation measured by Pd-porphyrin phosphorescence during severe hemorrhagic shock and low volume resuscitation with DCLHbin pigs

  • M van Iterson1,
  • M Sinaasappel1,
  • HR Hansen1,
  • CW Verlaan1,
  • K Burhop2,
  • A Trouwborst1 and
  • C Inee1
Critical Care19971(Suppl 1):P093

https://doi.org/10.1186/cc79

Published: 1 March 1997

Keywords

Systemic Blood PressureLight GuideLactate RingerSustained ImprovementStable Baseline

Introduction

Diaspirin crosslinked hemoglobin (DCLHb™, Baxter Healthcare Corp) is a hemoglobin based blood substitute which has been demonstrated to restore systemic blood pressure following hypovolemic shock at a low dose in pigs. In this study microvascular pO2 of the pig gut (pO2microv) was measured with a light guide attached to a phosphorimeter and using Pd-porphyrin quenching of phosphorescence [1], during shock and resuscitation. Resuscitation with DCLHb was compared to resuscitation with a combination of crystalloid and colloid.

Methods

Ten pigs (16 kg) were anesthetized, and ventilated with 33% O2 and 67% N2. Catheters were inserted, a length of ileum was extracted from the peritoneal cavity, and the fibre of a phosphorimeter placed on the serosa of the last 10 cm of the ileum. During preparation, Pd-porphyrin bound to albumin was injected intravenously. After stable baseline (BL), a severe hemorrhagic shock was induced by withdrawing 40 ml/kg (50% of circulating blood volume) of blood over 1 h. After 45 min of shock (ES) all pigs were randomly assigned to two groups. Resuscitation was performed over 20 min with either DCLHb™ (10%, 5 ml/kg) (DCLHb, n = 5) or a combination of lactated Ringers' solution (75 ml/kg) and gelofusine (15 ml/kg) (coll/cryst, n = 5). Observations were made every 15 min for 2h after resuscitation. Pd-porphyrin measurements were performed every 20 s.

Conclusion

Low volume resuscitation with DCLHb™ in pigs results in a more sustained improvement of microvascular pO2, measured by Pd-porphyrin phosphorescence, compared to resuscitation with a combination of large volume colloid and crystalloid.

Authors’ Affiliations

(1)
Department of Anesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
(2)
Baxter Healthcare Corporation, Round lake, USA

References

  1. Sinaasappel M, et al: Calibration of Pd-porphyrin phosphorescence for oxygen concentration measurements in vivo. J Appl Physiol. 1996, 81: 2297-2303.PubMedGoogle Scholar

Copyright

© Current Science Ltd 1997

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