Use of hemoglobin-based oxygen-carrying solution–201 to improve resuscitation parameters and prevent secondary brain injury in a swine model of traumatic brain injury and hemorrhage

Rosenthal, Guy; Morabito, Diane; Cohen, Mitchell J.; Roeytenberg, Annina; Derugin, Nikita; Panter, S. Scott; Knudson, M. Margaret; Manley, Geoffrey T.

doi:10.3171/jns/2008/108/3/0575

Cited by 39 publications

(25 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, a reduction in oxygen-carrying capacity during anemia may lead to inadequate regional cerebral oxygen delivery and secondary brain injury. Animal models of TBI with hemodilutional anemia [35] and hemorrhagic shock [36,37] indicate that reductions in PbtO2 occur when hemoglobin levels reach critically low values. Studies have shown that increasing hemoglobin concentrations with blood transfusions can increase PbtO2, depending on blood storage time [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Anemia is Associated with Metabolic Distress and Brain Tissue Hypoxia After Subarachnoid Hemorrhage

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Anemia is Associated with Metabolic Distress and Brain Tissue Hypoxia After Subarachnoid Hemorrhage

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The decrease in tissue oxygenation observed following the TBI may be due the impact having physical effects (e.g., pressure transmission) on remote brain areas, or may also reflect the phenomenon of transhemispheric diaschisis which alters brain activity contralateral to a cortical insult. 28 Older generation HBOCs have shown the utility of HBOCs in improving brain tissue oxygenation (e.g., HBOC-201 increased PbtO 2 in multiple TBI and anemia models [29][30][31][32] and This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Vasoactivity and Oxygenation with Oxygen Carrier M101 in Rats

Moon-MassatPaula

Habib-E-Rasul

AbutarboushRania

et al. 2017

Journal of Neurotrauma

View full text Add to dashboard Cite

The severity of traumatic brain injury (TBI) may be reduced if oxygen can be rapidly provided to the injured brain. This study evaluated if the oxygen-carrier M101 causes vasoconstricton of pial vasculature in healthy rats (Experiment 1) and if M101 improves brain tissue oxygen (PbtO) in rats with controlled cortical impact (CCI)-TBI (Experiment 2). M101 (12.5 mL/kg intravenous [IV] over 2 h) caused a mild (9 mm Hg) increase in the mean arterial blood pressure (MAP) of healthy rats without constriction of cerebral pial arterioles. M101 (12 mL/kg IV over 1 h) caused a modest (27 mm Hg) increase in MAP (peak, 123 ± 5 mm Hg [mean ± standard error of the mean]) of CCI-TBI rats and restored PbtO to near pre-injury levels. In both M101 and untreated control (NON) groups, PbtO was ∼30 ± 2 mm Hg pre-injury and decreased (p ≤ 0.05) to ∼16 ± 2 mm Hg 15 min after CCI. In NON, PbtO remained ∼50% of baseline but M101 administration resulted in a sustained increase in PbtO (peak, 25 ± 5 mm Hg), which was not significantly different from pre-injury until the end of the study, when it decreased again below pre-injury (but was still higher than NON). Histopathology showed no differences between groups. In conclusion, M101 increased systemic blood pressures without concurrent cerebral pial vasoconstriction (in healthy rats) and restored PbtO to 86% of pre-injury for at least 80 min when given soon after CCI-TBI. M101 should be evaluated in a clinically-relevant large animal model for pre-hospital treatment of TBI.

show abstract

“…The same system was used to collect physiological data in nonhuman experimentation as described previously by our group. 22 Variables displayed on the ; here, AIS A-E denote the post-resuscitation score; ISS = Injury Severity Score. 4 Characteristics of analyzed patients are shown with grouping based on change in neurological function by time of discharge.…”

Section: Data Collectionmentioning

confidence: 99%

Mean Arterial Blood Pressure Correlates with Neurological Recovery after Human Spinal Cord Injury: Analysis of High Frequency Physiologic Data

Hawryluk

Whetstone

Saigal

et al. 2015

Journal of Neurotrauma

Self Cite

199

169

View full text Add to dashboard Cite

Current guidelines for the care of patients with acute spinal cord injuries (SCIs) recommend maintaining mean arterial pressure (MAP) values of 85-90 mm Hg for 7 days after an acute SCI however, little evidence supports this recommendation. We sought to better inform the relationship between MAP values and neurological recovery. A computer system automatically collected and stored q1 min physiological data from intensive care unit monitors on patients with SCI over a 6-year period. Data for 100 patients with acute SCI were collected. 74 of these patients had American Spinal Injury Association Impairment Scale (AIS) grades determined by physical examination on admission and at time of hospital discharge. Average MAP values as well as the proportion of MAP values below thresholds were explored for values from 120 mm Hg to 40 mm Hg in 1 mm Hg increments; the relationship between these measures and outcome was explored at various time points up to 30 days from the time of injury. A total of 994,875 q1 min arterial line blood pressure measurements were recorded for the included patients amid 1,688,194 min of recorded intensive care observations. A large proportion of measures were below 85 mm Hg despite generally acceptable average MAP values. Higher average MAP values correlated with improved recovery in the first 2-3 days after SCI while the proportion of MAP values below the accepted threshold of 85 mm Hg seemed a stronger correlate, decreasing in strength over the first 5-7 days after injury. This study provides strong evidence supporting a correlation between MAP values and neurological recovery. It does not, however, provide evidence of a causal relationship. Duration of hypotension may be more important than average MAP. It provides support for the notion of MAP thresholds in SCI recovery, and the highest MAP values correlated with the greatest degree of neurological recovery. The results are concordant with current guidelines in suggesting that MAP thresholds >85 mm Hg may be appropriate after acute SCI.

show abstract

Use of hemoglobin-based oxygen-carrying solution–201 to improve resuscitation parameters and prevent secondary brain injury in a swine model of traumatic brain injury and hemorrhage

Cited by 39 publications

References 47 publications

Anemia is Associated with Metabolic Distress and Brain Tissue Hypoxia After Subarachnoid Hemorrhage

Anemia is Associated with Metabolic Distress and Brain Tissue Hypoxia After Subarachnoid Hemorrhage

Cerebral Vasoactivity and Oxygenation with Oxygen Carrier M101 in Rats

Mean Arterial Blood Pressure Correlates with Neurological Recovery after Human Spinal Cord Injury: Analysis of High Frequency Physiologic Data

Contact Info

Product

Resources

About