Abstract 118: Resuscitative Transfusion With Hemoglobin Vesicles in the Management of Post-Partum Hemorrhage

Abstract

Background: We developed a Hemoglobin vesicles (HbV), which are artificial substitute for Red blood cells (RBCs). Objective: To evaluate the efficacy of HbV for alternative treatment instead of RBCs transfusion in rabbits with hemorrhagic shock due to post-partum hemorrhage. Methods: New Zealand white rabbits at late gestation underwent uncontrolled hemorrhagic shock by transecting a right mid-artery in the myometrium, after cesarean section of right side uterus. Initially, in the simulated ordinal treatment of bleeding, rabbits received colloid fluids (Voluven®) through an femoral vein with equivalent volume of the bleeding every 5 minutes. Once blood loss achieved 100ml, animals subsequently faced on critical hemorrhagic situation, where mean arterial pressure (MAP) reduced to approximately 48mmHg. They were randomly divided into three isovolemic resuscitation regimens: continuing colloid fluid resuscitation (n=4); transfusion of autologous washed RBCs with plasma (n=4); HbV infusion combining 5% human serum albumin (n=4). After 60 minutes of bleeding, all animals underwent surgical control of bleeding and cesarean section of left side uterus. Results: At the point of critical hemorrhagic situation, Hb concentration reduced to 4.8 g/dl. At the end of resuscitation, HbV infusion regained MAP and restored Hb concentration as well as RBCs transfusion, besides colloid fluid resuscitation exaggerated the severe hemorrhagic shock as shown in the table. Conclusions: HbV treatment may be effective in the management of post-partum hemorrhagic shock.