Hemoglobin-based Oxygen Carrier (HBOC-201) and Escalating Doses of Recombinant Factor VIIa (rFVIIa) as a Novel Pre-hospital Resuscitation Fluid in a Swine Model of Severe Uncontrolled Hemorrhage

Abstract

Exsanguinating hemorrhage and unavailability of blood are major problems in pre-hospital trauma care. We investigated if combining rFVIIa with HBOC-201 reduces blood loss and improves physiologic parameters compared to HBOC alone. Swine underwent liver injury and were resuscitated with HBOC-201 alone or HBOC+90, 180 or 360 μg/kg rFVIIa before hospital arrival at 240 min; animals survived to 72 hours. Blood loss was reduced; MAP, CI, transcutaneous oxygen saturation, and 72-hour survival improved in the 90 and 180 μg/kg rFVIIa groups. Lactate was cleared faster in the HBOC+rFVIIa 90 μg/kg group. Verification in a large, well-powered study is indicated.

Keywords::

• hemorrhage
• resuscitation
• pre-hospital trauma care
• HBOC-201
• rFVIIa

Declaration of interest: Dr. Lewis Kaplan is a consultant for BioPure. Dr. Aryeh Shander is a consultant for and received research grants from NovoNordisk. I am a military service member (or employee of the U.S. Government). This work was prepared as part of my official duties. Title 17 U.S.C. §105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.