Hemoglobin-based oxygen carriers for hemorrhagic shock

被引:28
作者
Elmer, Jonathan [1 ,2 ]
Alam, Hasan B. [3 ]
Wilcox, Susan R. [4 ,5 ]
机构
[1] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA 02115 USA
[2] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Div Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA
[4] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA 02114 USA
[5] Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA
关键词
Hemorrhagic shock; Hemoglobin-based oxygen carriers; Blood alternatives; Transfusion; CROSS-LINKED HEMOGLOBIN; HUMAN POLYMERIZED HEMOGLOBIN; PRIMARY HIP-ARTHROPLASTY; BLOOD-TRANSFUSION; NITRIC-OXIDE; DOUBLE-BLIND; PERIOPERATIVE HYPOTENSION; RANDOMIZED-TRIAL; ACUTE TRAUMA; MULTICENTER;
D O I
10.1016/j.resuscitation.2011.09.020
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Hemorrhagic shock is a pathologic state in which intravascular volume and tissue oxygen delivery are impaired, leading to circulatory collapse and cellular ischemia. Resuscitation with hemoglobin-based oxygen carriers (HBOCs) is appealing in that their use can both restore intravascular volume and tissue oxygenation, without the limitations in supply and immunomodulatory effects of packed red blood cells. However, the development of safe and effective agents has been elusive. In this article, we briefly discuss the major limitations of traditional resuscitative fluids which have driven the continued interest in HBOCs. We then review the history of early HBOC development and the modern understanding of their mechanisms of toxicity, which has informed the rational design of second-generation agents. Finally, we provide an overview of these second-generation HBOCs that are under active investigation or have recently completed phase 3 clinical trials. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:285 / 292
页数:8
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