Hemorrhagic shock resuscitation with an artificial oxygen carrier, hemoglobin vesicle, maintains intestinal perfusion and suppresses the increase in plasma tumor necrosis factor-α

It is known that damage to the intestinal mucosa followed by systemic inflammatory response is one of the leading causes of shock related morbidity and mortality. In this study, we examined the ability of an artificial oxygen carrier hemoglobin vesicle (HbV) to sustain systemic and intestinal perfusion during hemorrhagic shock. In rabbits, hemorrhagic shock (40% of the estimated blood volume) was resuscitated with 5% albumin (alb group), HbV suspended in 5% albumin (HbVaIb group), or washed red blood cells suspended in 5% albumin (RBCaIb group). Plasma tumor necrosis factor (TNF)-α level was measured in rats under the same experimental protocol. No significant intergroup differences were seen in systemic hemodynamics. In contrast, parameters of intestinal perfusion significantly deteriorated in the alb group but were equally well sustained in the HbVaIb and RBCaIb groups. Also, a significant increase in plasma TNF-α level was seen in the alb group but not in the RBCaIb or HbVaIb groups. These results indicate the proficient oxygen transporting capability of HbV and its potential efficacy in shock resuscitation.