Hemostasis and Coagulation Following Uncontrolled Hemorrhage and Resuscitation with Polymerized Hemoglobin Based Oxygen Carrier (HBOC-201) in Swine

Abstract : Coagulopathy are common complications of hemorrhagic shock (HS). Recently HBOC-201, a novel fluid with oxygen carrying capacity, has been proposed for hypotensive resuscitation and stabilization of HS patients. Coagulation and hemostasis have been studied in a swine uncontrolled hemorrhage model comparing HBOC-201 to standard resuscitation fluids. Yucatan mini-pigs (n=24) underwent uncontrolled hemorrhage by laceration and crush injury of a liver lobe. These animals were either non-resuscitated or resuscitated with HBOC-201 or buffered hydroxyethyl starch (HEX) during the 4 hr period following HS, after which they received full hospital care up to 72 hr. In addition to in-vivo parameters (blood loss and in vivo bleeding time (BT)), changes in hemostasis were evaluated by laboratory assays (coagulation (PT, PTT, fibrinogen), thromboelastography (TEG), and closure (in vitro bleeding) time (PFA-CT). Lung histopathology was evaluated for evidence of adverse microvascular thrombogenic pathologic change.