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01-08-2008 | Experimental

Improved short-term survival with polyethylene glycol modified hemoglobin liposomes in critical normovolemic anemia

Authors: Andreas Pape, Harry Kertscho, Jens Meier, Oliver Horn, Mohamed Laout, Max Steche, Mischa Lossen, Alf Theisen, Bernhard Zwissler, Oliver Habler

Published in: Intensive Care Medicine | Issue 8/2008

Abstract

Objective

To investigate the efficacy of a polyethylene glycol (PEG) modified formulation of liposome-encapsulated hemoglobin (LEH) as an oxygen-carrying blood substitute in the treatment of critical normovolemic anemia.

Design and setting

Prospective, controlled, randomized experimental study in a university research facility.

Subjects

14 anesthetized and mechanically ventilated beagle dogs.

Interventions

Animals were splenectomized and hemodiluted by exchange of whole blood for iso-oncotic hetastarch (HES). Target parameter of the hemodilution protocol was the individual critical hemoglobin concentration (Hb_crit) corresponding with the onset of O₂ supply dependency of total body O₂ consumption. At Hb_crit animals were randomized to receive a bolus infusion (20 ml/kg) of either LEH (n = 7) or normal saline (NS; n = 7). Subsequently animals were observed without further intervention.

Measurements and results

The primary endpoint was survival time after the completion of treatment; secondary endpoints were parameters of central hemodynamics, O₂ transport and tissue oxygenation. Animals in the LEH group survived significantly longer after completion of treatment (149 ± 109 vs. 43 ± 56 min). Immediately after treatment LEH-treated animals presented with a more stable cardiovascular condition. After 30 min tissue O₂ tension on the surface of a skeletal muscle was significantly higher in the LEH group (23 ± 8 vs. 9 ± 2 mmHg). Nevertheless, treatment with LEH did not decrease mortality within the observation period.

Conclusions

In this present experimental study the infusion of a PEG-modified LEH provided adequate tissue oxygenation, hemodynamic stability, and a prolongation of survival time after critical anemia. However, these effects were sustained for only a short period of time.

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Title: Improved short-term survival with polyethylene glycol modified hemoglobin liposomes in critical normovolemic anemia
Authors: Andreas Pape
Harry Kertscho
Jens Meier
Oliver Horn
Mohamed Laout
Max Steche
Mischa Lossen
Alf Theisen
Bernhard Zwissler
Oliver Habler
Publication date: 01-08-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 8/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1082-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Improved short-term survival with polyethylene glycol modified hemoglobin liposomes in critical normovolemic anemia

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Subjects

Interventions

Measurements and results

Conclusions

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