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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Neurotrauma
2017 ; 34
(7
): 1337-1350
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gab.com Text
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Polynitroxylated Pegylated Hemoglobin-A Novel, Small Volume Therapeutic for
Traumatic Brain Injury Resuscitation: Comparison to Whole Blood and Dose Response
Evaluation
#MMPMID27869558
Brockman EC
; Jackson TC
; Dixon CE
; Bay?r H
; Clark RS
; Vagni V
; Feldman K
; Byrd C
; Ma L
; Hsia C
; Kochanek PM
J Neurotrauma
2017[Apr]; 34
(7
): 1337-1350
PMID27869558
show ga
Resuscitation with polynitroxylated pegylated hemoglobin (PNPH), a pegylated
bovine hemoglobin decorated with nitroxides, eliminated the need for fluid
administration, reduced intracranial pressure (ICP) and brain edema, and produced
neuroprotection in vitro and in vivo versus Lactated Ringer's solution (LR) in
experimental traumatic brain injury (TBI) plus hemorrhagic shock (HS). We
hypothesized that resuscitation with PNPH would improve acute physiology versus
whole blood after TBI+HS and would be safe and effective across a wide dosage
range. Anesthetized mice underwent controlled cortical impact and severe HS to
mean arterial pressure (MAP) of 25-27?mm Hg for 35?min, then were resuscitated
with PNPH, autologous whole blood, or LR. Markers of acute physiology, including
mean arterial blood pressure (MAP), heart rate (HR), blood gases/chemistries, and
brain oxygenation (PbtO(2)), were monitored for 90?min on room air followed by
15?min on 100% oxygen. In a second experiment, the protocol was repeated, except
mice were resuscitated with PNPH with doses between 2 and 100?mL/kg. ICP and 24?h
%-brain water were evaluated. PNPH-resuscitated mice had higher MAP and lower HR
post-resuscitation versus blood or LR (p?0.01). PNPH-resuscitated mice, versus
those resuscitated with blood or LR, also had higher pH and lower serum potassium
(p?0.05). Blood-resuscitated mice, however, had higher PbtO(2) versus those
resuscitated with LR and PNPH, although PNPH had higher PbtO(2) versus LR
(p?0.05). PNPH was well tolerated across the dosing range and dramatically
reduced fluid requirements in all doses-even 2 or 5?mL/kg (p?0.001). ICP was
significantly lower in PNPH-treated mice for most doses tested versus in
LR-treated mice, although %-brain water did not differ between groups.
Resuscitation with PNPH, versus resuscitation with LR or blood, improved MAP, HR,
and ICP, reduced acidosis and hyperkalemia, and was well tolerated and effective
across a wide dosing range, supporting ongoing pre-clinical development of PNPH
for TBI resuscitation.