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IV Perflubron emulsion versus autologous transfusion in severe normovolemic anemia: effects on left ventricular perfusion and function

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Research in Experimental Medicine

Abstract

Intact cardiac compensatory mechanisms are necessary to maintain adequate tissue oxygenation during acute normovolemic hemodilution (ANH). Left ventricular (LV) perfusion, oxygenation and function were analyzed in an experimental whole-body model of profound ANH (Hct 9%) and effectiveness of a perfluorocarbon-based oxygen carrier in maintaining myocardial oxygenation and function was evaluated. A total of 22 anesthetized dogs were hemodiluted to Hct 20% followed by a simulated, controlled blood-loss phase in which dogs were randomized to either: (1) 1:1 exchange of lost blood with autologous red blood cells (RBC-group), (2) 1:1 exchange with a colloid (control-group) and (3) 1:1 exchange with a colloid after a single dose of 1.8 g/kg BW perflubron iv (PFC-group). Myocardial oxygen delivery and consumption as well as endocardial perfusion were determined using radioactive microspheres. LV myocardial contractility (LV MC) was assessed from: (1) the relationship between maximum rate of LV pressure increase (LVdp/dtmax) and LV enddiastolic volume (LVEDV) and (2) analysis of the LV endsystolic pressure volume relationship (ESPVR). LV diastolic properties were reflected by (1) minimum rate of LV pressure increase (LVdp/dtmin), (2) slope and intercept of the enddiastolic pressure-volume relationship (EDPVR) and (3) the time-constant of isovolumic LV pressure decline “τ ½”. Full sets of LV MC data were obtained from 18 dogs (n =6 per group). LV MC (LVdp/dtmax - LVEDV relation) increased after perflubron administration. At the lowest Hct level, all parameters reflecting LV MC as well as LVdp/dtmin were significantly higher in the PFC-group than in the control-group. After profound normovolemic hemodilution (Hct 9%) superiority of LV MC and LV diastolic properties was found, when myocardial oxygenation was supported by iv perflubron emulsion, a temporary O2 carrier.

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Authors and Affiliations

  1. Institute for Surgical Research, University of Munich, Marchioninistrasse 15, D-81366, Munich, Germany

    Oliver Habler, Martin Kleen, Jörg Hutter, Armin Podtschaske, Mathias Tiede, Martin Welte, Carlos Corso & Konrad Messmer

  2. Institute for Anesthesiology, Ludwig-Maximilians University, Munich, Germany

    Oliver Habler, Martin Kleen, Gregor Kemming & Martin Welte

  3. Alliance Pharmaceutical Corporation, San Diego, Calif., USA

    Sanjay Batra, Peter Keipert & Simon Faithfull

Authors
  1. Oliver Habler
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  2. Martin Kleen
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  3. Jörg Hutter
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  4. Armin Podtschaske
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  5. Mathias Tiede
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  6. Gregor Kemming
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  7. Martin Welte
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  8. Carlos Corso
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  9. Sanjay Batra
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  10. Peter Keipert
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  11. Simon Faithfull
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  12. Konrad Messmer
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Corresponding author

Correspondence to Oliver Habler.

Additional information

The study was performed at the Institute for Surgical Research, University of Munich (LMU).

The study was supported in part by Alliance Pharmaceutical Corporation and by the R. W. Johnson Pharmaceutical Research Institute, Raritan, N.J. USA

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Habler, O., Kleen, M., Hutter, J. et al. IV Perflubron emulsion versus autologous transfusion in severe normovolemic anemia: effects on left ventricular perfusion and function. Res. Exp. Med. 197, 301–318 (1997). https://doi.org/10.1007/s004330050079

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  • DOI: https://doi.org/10.1007/s004330050079

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