THE EFFICACY OF DIASPIRIN CROSS-LINKED HEMOGLOBIN SOLUTION RESUSCITATION IN A MODEL OF UNCONTROLLED HEMORRHAGE

Controversy exists whether early aggressive fluid therapy in the setti ng 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. Anesthe tized rats (250-350 g) were subjected to a 50% tail transection and re suscitated 15 minutes later with 1:1 DCLHb, 3:1 lactated Ringer's solu tion (LR), 1:1 hypertonic saline (7.5% HTS), or 1:1 human serum albumi n (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 bloo d 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 re stored and maintained MAP and subcutaneous tissue oxygen tension at ba seline values better than all other resuscitative fluids. Although blo od loss in DCLHb-treated animals was greater than in unresuscitated an imals, it was no different from other resuscitative fluids and less th an with HSA. There was no difference in 24-hour survival between all t reatment groups. In conclusion, DCLHb elevates MAP but does not exacer bate blood loss or compromise tissue oxygen delivery compared with oth er resuscitative fluids in this model of uncontrolled hemorrhage.