Systemic Hemodynamic and Renal Effects of Unmodified Human Sfhs in Dogs

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Abstract
Isovolumic exchange transfusion (25% of total estimated blood volume) was carried out in the anesthetized dogs using 9 g/dl of unmodified human stroma-free hemoglobin solution (SFHS). The objective was to determine the systemic hemodynamic, blood distribution and renal effects of SFHS over a 2–3 hour period post-exchange. At 30 minutes after the exchange, blood pressure rose from 114±17 to 133±22 mmHg, but this rise was not sustained thereafter. Mean pulmonary arterial blood pressure rose from 8±3 to 13±2 mmHg, and remained above the preexchange level up to 3 hours post-exchange. Cardiac output remained within normal limits. Significant flow-increments were seen at 30 minutes in heart, brain, liver, gut, and kidney, but these were also not sustained. A fall in glomerular filtration rate (GFR) occurred after the exchange and remained below the pre-exchange level. A reduction In urine flow at 150 minutes post-exchange was observed and was accompanied by a reduction in urinary electrolyte excretion. The findings suggest that the initial effects of the administration of unmodified stroma-free hemoglobin solution are those of peripheral vasoconstriction which does not appear to significantly restrict flow to the vital organs, such as heart and brain. Unmodified hemoglobin was found cause a decrease in renal function.

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