Effects of a Novel Hemoglobin-Based Oxygen Carrier on Percent Oxygen Saturation as Determined With Arterial Blood Gas Analysis and Pulse Oximetry

Abstract

Study objective: Hemoglobin-based oxygen carrier 201 (HBOC-201) is a polymerized hemoglobin of bovine origin being developed for use in hemorrhage during surgery or trauma. Pulse oximetry is commonly used in clinical practice to assess percent saturation of hemoglobin (Sp O 2). The ability to measure Sp O 2 in the presence of HBOC-201 will be important for the use of this compound in patient care. Methods: We carried out a randomized, single-blind, placebo-controlled study at the Upjohn Research Clinics in Kalamazoo, Michigan, with normal, healthy adult men and women as subjects. The members of four groups of adult subjects (N=24) each received 45 g of HBOC-201 (nine each, men and women) or a control solution (Ringer's lactate) (three each, men and women). Each subject underwent phlebotomy (about 15% of estimated blood volume) followed by 3:1 hemodilution with Ringer's lactate and then either HBOC-201 or control solution. An indwelling arterial catheter in the radial artery was used for serial arterial blood gas sampling. Arterial blood gas measurements were made with a cooximeter (Instrumentation Laboratories). Fingertip pulse oximetry was used (Criticare 504-US; Criticare, Incorporated). Paired pulse oximetry and arterial blood gas sampling were made serially (at approximately hourly intervals) over 24 hours. Results: The mean ±SEM difference for Sp O 2 for arterial blood gas analysis compared with the pulse oximetry reading in the presence of HBOC-201 was 1.1%±.075% ; in controls it was .1% ± .064% ( P<.0001 for each) over the 24 hours after dosing. This relationship was constant despite increased concentrations of plasma hemoglobin (between 1 and 2 g/dL [10 to 20 g/L]) in the HBOC-201 groups. Conclusion: Accurate determinations of Sp O 2 can be made with pulse oximetry in subjects given HBOC-201 over the normal range of Sp O 2. [Hughes GS Jr, Francom SF, Antal EJ, Adams WJ, Locker PK, Yancey EP, Jacobs EE Jr: Effects of a novel hemoglobin-based oxygen carrier on percent oxygen saturation as determined with arterial blood gas analysis and pulse oximetry. Ann Emerg Med February 1996;27:164-169.]