Détail de la notice
Titre du Document
Does OxyVita, a New-Generation Hemoglobin-Based Oxygen Carrier, or Oxyglobin Acutely Interfere With Coagulation Compared With Normal Saline or 6% Hetastarch? An Ex Vivo Thromboelastography Study
Auteur(s)
JAHR Jonathan S. ; WEEKS David L. ; DESAI Poonam ; ...
Résumé
Objectives: Because hetastarches have deleterious effects on coagulation that increase with molecular weight (MWt), risk of coagulopathy associated with a high MWt hemoglobin-based oxygen carrier (HBOC) was studied. Design: Preliminary laboratory study of donor blood using thromboelastography (TEG). Setting: University laboratory. Participants: Volunteer donor blood. Interventions: Experiments simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOCs. Coagulopathy related to 1:11, 1:5, 1:2, or 1:1 dilution of whole blood with normal saline, 6% hetastarch (670 kilodaltons [kD]), hemoglobin glutamer-200 (HBOC-200, 200 kD), or OxyVita (OXYVITA Inc, New Windsor, NY) (a new-generation, zero-link polymerized bovine hemoglobin-based oxygen carrier, 33 megadaltons) were analyzed. Measurements and Main Results: At 2 lower levels of hemodilution, hetastarch, HBOC-200, and OxyVita produced equivalent reductions in maximum clot strength (TEG-MA and TEG-G) that reached statistical significance compared with whole blood and normal saline. At 2 higher dilutions, OxyVita and HBOC-200 impaired maximum clot strength compared with whole blood, normal saline, and hetastarch. Dilution with hetastarch had a greater effect on clot propagation (K and a) than either HBOC. Conclusions: OxyVita and HBOC-200, HBOCs with different MWt, had similar effects on coagulation as measured by TEG. The impairment of coagulation by HBOCs and hetastarch occurred at doses
Editeur
Elsevier
Identifiant
PMID : 18249328 ISSN : 1053-0770
Source
Journal of cardiothoracic and vascular anesthesia A. 2008, vol. 22, n° 1, pp. 34-39 [6 pages]
Langue
Anglais
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