DIASPIRIN CROSS-LINKED HEMOGLOBIN (DCLHB(TM)) ATTENUATES BACTERIAL TRANSLOCATION IN RATS

Intestinal barrier function is compromised following severe hemorrhage which may allow bacterial translocation (BT) to occur and subsequentl y initiate a systemic response leading to multiple system organ failur e (MSOF). This study compared BT following hemorrhage and resuscitatio n with lactated Ringer's solution (LR) or diaspirin crosslinked hemogl obin solution (DCLHb(TM)). Rats (250-350 grams) were hemorrhaged to a base deficit of 15 +/- 2 mmol/L and immediately resuscitated with eith er 3:1 LR or 1:1 DCLHb based on shed blood volume. Four hours followin g resuscitation, the mesenteric lymph node complex was harvested, homo genized and plated onto MacConkey and Columbia CNA agar culture media. Facultative anaerobic and obligate aerobic bacteria were identified 4 8 hours later in 11/22 (50%) LR-treated rats and in 4/21 (19%) DCLHb-t reated rats (p < 0.05). Following resuscitation, base excess (BE) and central venous oxygen saturation (SvO(2)) were not only restored to ba seline but were significantly greater (p less than or equal to 0.05) i n DCLHb-treated rats than in LR-treated rats. In a separate group of r ats subjected to the same hemorrhage and resuscitation protocol, mean arterial pressure in DCLHb-treated rats, but not LR-treated rats, was restored to baseline by 15 minutes and remained at or above baseline f or up to 4 hrs. Twenty-four hour survival was 50% in LR-treated rats a nd 77% in DCLHb-treated rats (p > 0.05). These data suggest that DCLHb is superior to LR in restoring tissue oxygen delivery, as judged by B E and SvO(2). Furthermore, since DCLHb restores oxygen delivery and at tenuates BT, early resuscitation with DCLHb may limit gut ischemia and subsequent gut barrier failure and hence prevent the development of s epsis, MSOF and subsequent death.