Abstract 11934: Resuscitation by Transfusion With Hemoglobin Vesicles in Trauma Hemorrhagic Shock / Coagulopathy Rabbits

Abstract

Introduction: We have developed Hemoglobin vesicle (HbV) as an artificial substitute for Red blood cells (RBC). Hypothesis: To evaluate the efficacy of HbV for alternative treatment of massive transfusion protocol (MTP) in traumatic hemorrhagic shock / coagulopathy rabbits. Methods: Hemorrhagic shock / thrombocytopenia were induced in rabbits by repeated blood withdrawal (total 400ml) and isovolemic transfusion of autologous washed RBC. Liver penetrating injury led lethal oozing hemorrhage. Balloon compression and Platelet rich plasma (PRP) administration stopped bleeding. Thereafter, allogenic RBC transfusion, HbV or 5% Albumin was administered to the animals (n=30). Acute prognosis was compared among them for 24 hr. Hemodynamic and hematologic parameters were periodically recorded for first 1hr. Results: In anemic and thrombocytopenic rabbits (Hb < 6.0 g/dl, platelets < 40,000 /μL, mean arterial pressure (MAP) < 50 mmHg), liver penetrating injury caused additional bleeding and animals suffered class IV shock (Hb < 5.0 g/dl, MAP < 40 mmHg). PRP administration restored platelets ≧ 70,000 /μL, which stopped bleeding within 40 min. Subsequent administration of HbV as well as RBC transfusion regained MAP more than 50 mmHg, and they rescued 70 % animals from liver hemorrhage, although rabbits receiving 5% albumin showed 10% survival in the first 24 hours. HbV administration did not affect the coagulation parameters as well as RBC transfusion. Conclusions: HbV may be effectively instead of RBCs for acute hemorrhagic shock and trauma induced coagulopathy.