BJA Advance Access originally published online on August 26, 2009
British Journal of Anaesthesia 2009 103(4):496-504; doi:10.1093/bja/aep233
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Administration of bovine polymerized haemoglobin before and during coronary occlusion reduces infarct size in rabbits
1 Department of Anaesthesiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Germany.
2 Department of Anaesthesiology and Critical Care Medicine, Academic Hospital Solingen, Germany.
3 Department of Cardiology and Pneumology, Altona General Hospital, Hamburg, Germany.
4 Department of Radiology, Children's Hospital Altona, Hamburg, Germany.
5 Department of Anaesthesiology and Intensive Care Medicine, University Hospital Muenster, Germany.
6 Department of Anaesthesiology, University Hospital Hamburg Eppendorf, Germany.
7 Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Knappschaftskrankenhaus Bochum Langendreer, University Hospital Bochum, Germany
* Corresponding author. E-mail: gottschalk.andre{at}gmx.de
Background: Haemoglobin-based oxygen carriers (HBOC) seem to increase the risk of mortality and myocardial infarction in clinical trials. Therefore, we designed this randomized placebo-controlled animal study to evaluate the effects of prophylactic and therapeutic administration of HBOC in a myocardial ischaemia–reperfusion model with respect to infarct size and areas of impaired perfusion (no reflow, NR).
Methods: Thirty-two anaesthetized, mechanically ventilated rabbits were randomized to one of the four groups. Group G1 received 0.4 g kg–1 i.v. HBOC-200 25 min before coronary artery occlusion, G2 received the same dose i.v. 10 min after occlusion, and G3 and 4 received i.v. saline. G1, 2, and 3 were subjected to 30 min occlusion of left coronary artery followed by 240 min of reperfusion. G4 was treated without ischaemia–reperfusion. Measurement included assessment of the area at risk and infarct size using triphenyltetrazolium chloride stain and areas of NR using thioflavin stain. Ischaemia–reperfusion was confirmed by microspheres technique.
Results: Infarct size as a percentage of the area at risk was significantly reduced in G1 [25 (SD 13)%, P=0.026] and G2 [22 (20)%, P=0.009] compared with G3 [48 (17)%]. The areas of NR in percentage of the area at risk [G1, 26 (15)%; G2, 34 (22)%; G3, 36 (12)%; G4, 5 (3)%] did not differ between the groups of animals undergoing coronary occlusion and reperfusion.
Conclusions: Prophylactic and therapeutic administration of HBOC-200 reduces infarct size in myocardial ischaemia and reperfusion in rabbits. This reduction of infarct size is not accompanied by an improvement of areas of NR.
Keywords: heart, coronary occlusion; heart, ischaemia; model, rabbit
Declaration of interest. M.-A.B. is employed by B. Braun Melsungen AG, Melsungen, Germany, an international Medical Device and Pharmaceutical Manufacturer.
This article is accompanied by Editorial III.
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