THE EFFECTS OF A BLOOD-SALVAGING DEVICE ON BLOOD CONTAINING A HEMOGLOBIN-BASED OXYGEN CARRIER, HBOC-201

Objectives: Hemoglobin-based oxygen carriers will be used concurrently with intraoperative blood salvage. The effects of salvage and process ing on blood containing one such solution (HBOC-201; Biopure Corp, Bos ton, MA) were studied. Design: Prospective, randomized. Setting: Labor atory, Interventions: Sixteen blood units from healthy volunteers had either HBOC (1,500 mg/dL; n = 10) or normal saline (equivalent volume; n = 6) added. All units were salvaged and processed using a blood sal vage device. Samples were analyzed for the concentration and molecular weight distribution of plasma hemoglobin and red cell morphology pres alvage (pre) and following processing and washing (post 1). Five of th e HBOC units underwent a second 1,000 mL wash (post 2).Measurements an d Main Results: Processing and washing decreased the concentration of plasma hemoglobin (mg/dL) in HBOC units (1311 +/- 265 pre to 27.8 +/- 19.6 post 1 to 6.5 +/- 2.19 post 2), but did not change the plasma hem oglobin concentration in saline units (2.05 +/- 1.27 pre v 3.18 +/- 0. 79 post 1). Total plasma hemoglobin in HBOC units (6.56 +/-: 2.19) was significantly greater than in saline units (3.18 +/- 0.79), even afte r the second wash (post 2). The concentration of unstable hemoglobin i n the plasma phase was not different between groups. Red cell morpholo gy was altered by the salvage process but was not different between gr oups. Conclusions: Salvage and processing of blood containing HBOC yie ld concentrated red cells that are indistinguishable from those obtain ed from blood without HBOC. Residual HBOC remains but is unchanged fro m the HBOC initially administered. Copyright (C) 1997 by W.B. Saunders Company.