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489 NONINVASIVE IN VIVO MONITORING OF TISSUE HEMOGLOBIN CONTENTS AFTER HEMOGLOBIN-BASED OXYGEN CARRIER INFUSION IN RABBIT HYPOVOLEMIC SHOCK MODEL.
  1. J. Lee,
  2. S. Mahon,
  3. K. Kreuter,
  4. D. Mukai,
  5. A. Cerussi,
  6. B. Tromberg,
  7. M. Brenner
  1. Beckman Laser Institute and Pulmonary Division, University of California, Irvine, Irvine, CA

Abstract

Introduction Despite their oxygen carrying capacities, the efficacy of hemoglobin-based oxygen carrier (HBOC) transfusion has been complicated by several side effects including hemodilution due to high oncotic properties and vasoconstriction from nitric oxide scavenging. Therefore, it is important to monitor in vivo tissue hemoglobin contents (oxy- and deoxyhemoglobin concentrations ([OxyHb], [DeOxyHb]), and tissue oxygen saturation (StO2) to evaluate the physiologic effects of HBOC transfusion. In this study, the feasibility of a noninvasive diffuse optical spectroscopy (DOS) system to monitor in vivo tissue hemoglobin concentrations during HBOC infusion is demonstrated using a rabbit hypovolemic shock model.

Material and Methods Hemorrhage and fluid replacement in intubated New Zealand White rabbits (N = 6) was accomplished by 20% blood loss and slow infusion of Hb glutamer-200 (Hb-200) (Oxyglobin, Biopure, 0.5 mL/min). The DOS prototype probe was placed on the right inner thigh muscle of the hind leg to assess concentrations of [OxyHb], [DeOxyHb], total tissue hemoglobin concentration (THC = [OxyHb] + [DeOxyHb]) as well as StO2 during bloodletting and volume expansion. These values were compared against traditional invasive measurements. Serum hemoglobin concentration (sHgb), systemic blood pressure, heart rate, and blood gas were monitored at regular intervals throughout the experiment.

Results THC and sHgb during shock and HBOC infusion (Figure 1) demonstrate that DOS was able to detect the restoration of THC in tissue after Hb-200 infusion, while systemic sHgb continued to decrease due to significant hemodilution. DOS also enables measurements of tissue hemoglobin oxygen saturation status from quantification of [OxyHb] and [DeOxyHb].

Conclusion DOS enables noninvasive in vivo monitoring of oxygen carrying capacity during shock and volume expansion with HBOC and renders insight on distribution of artificial blood substitute at the tissue level.

FIGURE 1

Fractional changes of THC and sHgb from baseline during hemorrhage and resuscitation using oxyglobin.

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