Comparison of the macro-circulatory effects of the new generation plasma expander EAF-hexaPEGylated albumin (EAF-PEG-BSA) in a rabbit hemorrhagic shock model

A comparison with conventional crystalloid and colloid solutions

P. L. To, R. A. Gunther, J. S. Jahr, R. J. Holtby, B. Driessen, S. A. Acharya, P. C. Chen, A. T W Cheung

Research output: Contribution to journalArticle

Abstract

Introduction: HexaPEGylated albumin (PEG-BSA) is a new class of low viscosity Nitric Oxide (NO) producing active plasma expander.The macro-circulatory response to PEG-BSA of a 4 gm solution of PEG-BSA was studied in a rabbit hemorrhagic shock and resuscitation model and compared that of 0.9% sodium chloride and albumin 25%. Methods: Five New Zealand white rabbits were anesthetized utilizing ketamine with diazepam and propofol. Endotracheal intubation was performed, animals were ventilated, and anesthesia maintained with isoflurane and diazepam. Following placement of vascular lines for measuring physiological variables, 45 minutes were allowed for equilibration prior to collecting baseline values laboratory and physiologic values. Animals were bled over 30 min to reach a Mean Arterial Pressure (MAP) of 30-41 mmHg.This pressure was maintained for an additional 30 min. Post-Hemorrhage (PH) values were recorded one hour after initiation. Results: The hematocrit decreased by hemorrhagic shock, and the Heart Rate (HR) returned to the baseline in all 25% PEG-BSA rabbits and in 75% PEG-BSA, HR was greater than baseline. In the saline group, MAP and SvO2 returned to baseline values, the restitution of the baseline value was least effective with albumin, while with PEG albumin the values returned to near control values. Cardiac Output (CO) did not return to the baseline values when resuscitated with saline or 25% albumin, but returned close to the baseline with PEG-BSA both with the 25% and exceeding the baseline value in the 75% group. The pH returned to baseline in all rabbits, whereas lactate increased, remaining elevated relative to the baseline. Conclusion: The responses to the resuscitation by the three fluids in rabbit hemorrhagic chock models are distinct. Resuscitation with 0.9% sodium chloride, improves only MAP and SvO2 suggesting improved responses. The PEG-BSA as well as albumin, improved MAP, SvO2, HR, pH, and lactate, but PEG-BSA at lower levels compared to albumin.

Original languageEnglish (US)
JournalJournal of Anesthesia and Clinical Research
Volume4
Issue number8
DOIs
StatePublished - 2013

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Cohort Effect
Hemorrhagic Shock
Colloids
Albumins
Rabbits
Arterial Pressure
Resuscitation
Heart Rate
Diazepam
Sodium Chloride
Lactic Acid
Intratracheal Intubation
Isoflurane
Ketamine
Propofol
crystalloid solutions
Hematocrit
Viscosity
Cardiac Output
Blood Vessels

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Comparison of the macro-circulatory effects of the new generation plasma expander EAF-hexaPEGylated albumin (EAF-PEG-BSA) in a rabbit hemorrhagic shock model : A comparison with conventional crystalloid and colloid solutions. / To, P. L.; Gunther, R. A.; Jahr, J. S.; Holtby, R. J.; Driessen, B.; Acharya, S. A.; Chen, P. C.; Cheung, A. T W.

In: Journal of Anesthesia and Clinical Research, Vol. 4, No. 8, 2013.

Research output: Contribution to journalArticle

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abstract = "Introduction: HexaPEGylated albumin (PEG-BSA) is a new class of low viscosity Nitric Oxide (NO) producing active plasma expander.The macro-circulatory response to PEG-BSA of a 4 gm solution of PEG-BSA was studied in a rabbit hemorrhagic shock and resuscitation model and compared that of 0.9{\%} sodium chloride and albumin 25{\%}. Methods: Five New Zealand white rabbits were anesthetized utilizing ketamine with diazepam and propofol. Endotracheal intubation was performed, animals were ventilated, and anesthesia maintained with isoflurane and diazepam. Following placement of vascular lines for measuring physiological variables, 45 minutes were allowed for equilibration prior to collecting baseline values laboratory and physiologic values. Animals were bled over 30 min to reach a Mean Arterial Pressure (MAP) of 30-41 mmHg.This pressure was maintained for an additional 30 min. Post-Hemorrhage (PH) values were recorded one hour after initiation. Results: The hematocrit decreased by hemorrhagic shock, and the Heart Rate (HR) returned to the baseline in all 25{\%} PEG-BSA rabbits and in 75{\%} PEG-BSA, HR was greater than baseline. In the saline group, MAP and SvO2 returned to baseline values, the restitution of the baseline value was least effective with albumin, while with PEG albumin the values returned to near control values. Cardiac Output (CO) did not return to the baseline values when resuscitated with saline or 25{\%} albumin, but returned close to the baseline with PEG-BSA both with the 25{\%} and exceeding the baseline value in the 75{\%} group. The pH returned to baseline in all rabbits, whereas lactate increased, remaining elevated relative to the baseline. Conclusion: The responses to the resuscitation by the three fluids in rabbit hemorrhagic chock models are distinct. Resuscitation with 0.9{\%} sodium chloride, improves only MAP and SvO2 suggesting improved responses. The PEG-BSA as well as albumin, improved MAP, SvO2, HR, pH, and lactate, but PEG-BSA at lower levels compared to albumin.",
author = "To, {P. L.} and Gunther, {R. A.} and Jahr, {J. S.} and Holtby, {R. J.} and B. Driessen and Acharya, {S. A.} and Chen, {P. C.} and Cheung, {A. T W}",
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T2 - A comparison with conventional crystalloid and colloid solutions

AU - To, P. L.

AU - Gunther, R. A.

AU - Jahr, J. S.

AU - Holtby, R. J.

AU - Driessen, B.

AU - Acharya, S. A.

AU - Chen, P. C.

AU - Cheung, A. T W

PY - 2013

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AB - Introduction: HexaPEGylated albumin (PEG-BSA) is a new class of low viscosity Nitric Oxide (NO) producing active plasma expander.The macro-circulatory response to PEG-BSA of a 4 gm solution of PEG-BSA was studied in a rabbit hemorrhagic shock and resuscitation model and compared that of 0.9% sodium chloride and albumin 25%. Methods: Five New Zealand white rabbits were anesthetized utilizing ketamine with diazepam and propofol. Endotracheal intubation was performed, animals were ventilated, and anesthesia maintained with isoflurane and diazepam. Following placement of vascular lines for measuring physiological variables, 45 minutes were allowed for equilibration prior to collecting baseline values laboratory and physiologic values. Animals were bled over 30 min to reach a Mean Arterial Pressure (MAP) of 30-41 mmHg.This pressure was maintained for an additional 30 min. Post-Hemorrhage (PH) values were recorded one hour after initiation. Results: The hematocrit decreased by hemorrhagic shock, and the Heart Rate (HR) returned to the baseline in all 25% PEG-BSA rabbits and in 75% PEG-BSA, HR was greater than baseline. In the saline group, MAP and SvO2 returned to baseline values, the restitution of the baseline value was least effective with albumin, while with PEG albumin the values returned to near control values. Cardiac Output (CO) did not return to the baseline values when resuscitated with saline or 25% albumin, but returned close to the baseline with PEG-BSA both with the 25% and exceeding the baseline value in the 75% group. The pH returned to baseline in all rabbits, whereas lactate increased, remaining elevated relative to the baseline. Conclusion: The responses to the resuscitation by the three fluids in rabbit hemorrhagic chock models are distinct. Resuscitation with 0.9% sodium chloride, improves only MAP and SvO2 suggesting improved responses. The PEG-BSA as well as albumin, improved MAP, SvO2, HR, pH, and lactate, but PEG-BSA at lower levels compared to albumin.

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