Effects of a Hemoglobin-Based Oxygen Carrier (HBOC-201) on Hemodynamics and Oxygen Transport in Patients Undergoing Preoperative Hemodilution for Elective Abdominal Aortic Surgery

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Abstract
We conducted a pilot study to evaluate the effects of HBOC-201, a bovine hemoglobin-based oxygen carrier, on hemodynamics and oxygen transport in patients un- dergoing preoperative hemodilution for elective ab- dominal aortic surgery. After induction of anesthesia and isovolemic hemodilution with 1 L of lactated Ring- er's solution, 13 patients were randomly assigned to re- ceive, within 30 min, 3 mL/kg of either HBOC-201 or 6% hydroxyethyl starch (HES). Monitored variables included invasive arterial and pulmonary artery pres- sures, arterial and mixed venous blood gases, and cal- culations of cardiac index (CI), systemic and pulmo- nary vascular resistance indices, oxygen delivery index (Do&, oxygen consumption index (Vo,I), and oxygen extraction ratio (0,ER). Thirty minutes after HBOC-201 infusion, mean arterial pressure, systemic vascular re- sistance index, and CI were 149% (P = 0.028), 169% (P = 0.046), and 75% (P = 0.046) of the preinfusion values, respectively. No significant changes were noticed in heart rate and pulmonary vascular resistance index. Do,1 and Vo,I, 30 min after the infusion of HBOC-201, were 79% (P = 0.046) and 76% (P = 0.028) of the prein- fusion values, respectively, whereas Cao, and 0,ER re- mained unaffected. We conclude that HBOC-201, at a dose of 3 mL/kg, impairs oxygen delivery because of adverse effects on cardiac output.