Controversy exists whether early aggressive
fluid therapy in the setting of uncontrolled
hemorrhage worsens outcome by increasing blood loss from injured vessels. Since
diaspirin crosslinked
hemoglobin (
DCLHb) is a vasoactive,
oxygen-carrying
solution, we compared the effects of
DCLHb with other resuscitative fluids on blood loss, hemodynamics, and tissue
oxygen delivery in a model of uncontrolled
hemorrhage. Anesthetized rats (250-350 g) were subjected to a 50% tail transection and resuscitated 15 minutes later with 1:1
DCLHb, 3:1
lactated Ringer's solution (LR), 1:1 hypertonic saline (7.5% HTS), or 1:1
human serum albumin (8.3% HSA) based on initial volume of blood loss (average 4.7 +/- 0.3 mL/kg). An unresuscitated group served as a control. Cumulative blood loss was measured at 5 hours postresuscitation. By 15 minutes after tail transection, mean arterial pressure (MAP) decreased 19.2 +/- 3.8 mm Hg from the baseline value (102 +/- 5 mm Hg). The
DCLHb solution restored and maintained MAP and subcutaneous tissue
oxygen tension at baseline values better than all other resuscitative fluids. Although blood loss in
DCLHb-treated animals was greater than in unresuscitated animals, it was no different from other resuscitative fluids and less than with HSA. There was no difference in 24-hour survival between all treatment groups. In conclusion,
DCLHb elevates MAP but does not exacerbate blood loss or compromise tissue
oxygen delivery compared with other resuscitative fluids in this model of uncontrolled
hemorrhage.