A Comparison of the Acute Hemodynamic and Delayed Effects of 50% Exchange Transfusion with Two Different Cross-linked Hemoglobin Based Oxygen Carrying Solutions and Pentastarch

Background: Hemoglobin based oxygen carrying solutions (HBOC) have been designed to combine the beneficial effects of colloidal solutions with oxygen carrying capacity. Clinical trials in humans using HBOCs have had variable results. Methods: We used a rodent 50% exchange model to compare HemolinkTMand HemopureTM HBOC to autologous blood and Pentastarch solution. We monitored hemodynamic parameters, hemoglobin clearance, weight gain and hematocrit over a five-day period. Results: Acute hemodynamic effects between the two HBOCs were similar with mild vasoconstriction. Cardiac output, systemic vascular resistance and renal function were similar to that seen with blood. HBOC's were associated with hemoglobinuria with a half-life in the circulation of 13.8 hrs for Hemolink and 19.2 hrs for Hemopure. Animals resuscitated with HBOCs exhibited delayed weight gain. Conclusion: Hemodynamic effects in rodents exchange-transfused with blood, HemolinkTM, or HemopureTM were similar. The delayed weight gain observed with the HBOCs must be investigated.