HBOC-201 improves survival in a swine model of hemorrhagic shock and liver injury

Background: Blunt abdominal trauma that leads to hemorrhagic shock and cardiac arrest is almost always fatal in the prehospital setting. The current study investigated whether a hemoglobin-based oxygen carrier (HBOC-201) could maintain organ viability during an exsanguinating liver injury and allow for prolonged survival. This hypothesis was tested in a large animal model that simulated blunt abdominal trauma with major organ injury. Methods: Swine underwent a liver crush, laceration and 50 ml/kg initial blood loss. The liver bled at 3 ml/kg per min during the resuscitation phase. No fluid (NF = 6), hetastarch (HES = 8), or HBOC-201 (HBOC = 8) was given during the resuscitation phase. Swine alive 60 min after the initial injury underwent liver repair and 96 h observation. Results: All HBOC swine survived 60 min versus none of the NF or HES swine (P < 0.05). All HBOC swine survived 24 h and 7/8 survived 96 h with good functional recovery. Conclusions: HBOC resuscitation during liver bleeding in a swine model of hemorrhagic shock and liver injury allowed for 96 h survival. No fluid or HES in the same model was fatal. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.