Systemic hemodynamics and renal function in hemorrhaged dogs resuscitated with cross-linked hemoglobin

Cross-linked hemoglobin (XL-Hb) infused into dogs increases mean arterial p ressure (MAP) but decreases blood flow to the renal (RBF), mesenteric (MBF) , and iliac (IBF) circulations. These actions differ markedly from dextran infusion (which increases RBF, MBF, and IBF without altering MAP) and may b e due to scavenging of nitric oxide by XL-Hb. However, because the hormonal milieu regulating regional circulation is altered during hemorrhage (when XL-Hb, may be used), me studied whether systemic hemodynamics, RBF, MBF, IB F, and renal excretory function in hemorrhaged dogs was altered when resusc itated with XL-Hb compared with dextran (n = 6 each). Hemorrhage decreased MAP by 25% due to a 75% decline in cardiac output. RBF, MBF, and IBF all fe ll by 33, 64, and 72%, respectively (P < 0.05 each). There was also a fall in glomerular filtration rate (GFR), urinary flow, and sodium excretion (P < 0.05 each). After resuscitation, MAP, cardiac output, RBF, MBF, IBF, and GFR all recovered to basal values with either XL-HI, or dextran. Urinary fl ow and sodium excretion increased to above basal levels with dextran (both by 3.5-fold; P < 0.05) or XL-Hb (by 7.5- and 10-fold, respectively; P < 0.0 5). We conclude that resuscitation with XL-Hb after hemorrhage not only inc reases MAP, but, also restores RBF, MBF, IBF, GFR, and urinary sodium and v olume excretion analogously to dextran. The results contrast with those in normal dogs and suggest that nitric oxide inhibition does not impair hemody namic and renal function recovery during hemorrhage.