Methemoglobin Effects on Coagulation: A Dose-Response Study With HBOC-200 (Oxyglobin) in a Thrombelastogram Model
Objectives Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemogl...
Saved in:
Published in | Journal of cardiothoracic and vascular anesthesia Vol. 23; no. 1; pp. 41 - 47 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.02.2009
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Objectives Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied. Design A laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL). Setting A university laboratory. Participants Volunteer donor blood. Interventions Blood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed. Measurements and Main Results Analysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (α) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, α) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin). Conclusions High methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible. |
---|---|
AbstractList | Objectives Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied. Design A laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL). Setting A university laboratory. Participants Volunteer donor blood. Interventions Blood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed. Measurements and Main Results Analysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (α) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, α) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin). Conclusions High methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible. Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied. A laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL). A university laboratory. Volunteer donor blood. Blood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed. Analysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (α) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, α) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin). High methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible. OBJECTIVESBecause oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied.DESIGNA laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL).SETTINGA university laboratory.PARTICIPANTSVolunteer donor blood.INTERVENTIONSBlood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed.MEASUREMENTS AND MAIN RESULTSAnalysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (alpha) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, alpha) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin).CONCLUSIONSHigh methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible. Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have additive adverse effects on coagulation. The risk of coagulopathy after different dilutions of HBOC-200 with low and high methemoglobin concentrations was studied. A laboratory study on donor blood using thromboelastography (TEG; Haemoscope, Niles, IL). A university laboratory. Volunteer donor blood. Blood samples simulated hemodilution during clinical resuscitation of hemorrhagic shock with varying doses of HBOC-200 (Oxyglobin; Biopure Corp, Cambridge, MA). Coagulopathy related to 1:11, 1:5, 1:2, and 1:1 dilution of whole blood with HBOC-200 high methemoglobin concentrations (65%) and HBOC-200 low methemoglobin concentrations (1%) were analyzed. Analysis of fixed effects of dilution on coagulation showed that the progressive dilution of HBOC-200 (low methemoglobin) and HBOC-200 (high methemoglobin) produced significant prolongation in reaction time (R) and clot propagation (K) and significant decreases in clot kinetics (alpha) and clot strength (MA and G). Analysis of fixed effects of treatment group on coagulation showed that clot propagation (K, alpha) and clot strength (MA and G) are significantly different in HBOC-200 (high methemoglobin) compared with HBOC-200 (low methemoglobin). High methemoglobin concentrations in HBOC-200 cause additive coagulation impairment that likely results from the effects of oxidative substances on platelet function and coagulation proteins. Oxidative products adversely react with coagulation factors and modify redox-sensitive sites in the platelets. Therefore, if methemoglobinemia occurs as a result of HBOC administration and if the levels are significantly elevated (greater than 10%), impairment of coagulation is possible. |
Author | Lim, Jennifer C Weeks, David, PhD, MD Driessen, Bernd, DVM, PhD Jahr, Jonathan S., MD Moallempour, Mojgan, MD Butch, Anthony, PhD |
Author_xml | – sequence: 1 fullname: Moallempour, Mojgan, MD – sequence: 2 fullname: Jahr, Jonathan S., MD – sequence: 3 fullname: Lim, Jennifer C – sequence: 4 fullname: Weeks, David, PhD, MD – sequence: 5 fullname: Butch, Anthony, PhD – sequence: 6 fullname: Driessen, Bernd, DVM, PhD |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18834828$$D View this record in MEDLINE/PubMed |
BookMark | eNp9kc1u1DAURi1URH_gBVgg74BFgu3EsQchpDIUitRqJFrE0nLs6xkPSTy1k4p5exzNSEgsWPkuvu_o-txzdDKEARB6SUlJCa_ebcvto9ElI0SWpCkJaZ6gM8orVsiasZM851RBhCCn6DylLSGUci6eoVMqZVVLJs_Qwy2MG-jDugutH_CVc2DGhMOAl0Gvp06PPgzv8SX-HBIU3yHtwpAA342T3eOfftzg60-rZZF3wG9Wv_cHzFucURrfb2LoW-h0GsM66h7fBgvdc_TU6S7Bi-N7gX58ubpfXhc3q6_flpc3hakpGTPRCQ60qnnlWs0WkjdUCBB1DY21XLvK8FZSYxvmaiIa4phtuXV1LWzumuoCvT5wdzE8TJBG1ftkoOv0AGFKSlTVgoqFJDnJDkkTQ0oRnNpF3-u4V5So2aHaqtm0mk0r0qhsOpdeHfFT24P9WzmqzYEPhwDkTz56iCoZD4MB62N2rGzw_-d__KduOj94o7tfsIe0DVMcsj5FVWKKqLuZM5-ayHxmyWj1B3zKpN0 |
CitedBy_id | crossref_primary_10_1093_bja_aep233 crossref_primary_10_3389_fmedt_2022_989829 crossref_primary_10_1111_j_1476_4431_2012_00726_x crossref_primary_10_1016_j_vph_2009_12_005 crossref_primary_10_1007_s10047_010_0528_6 crossref_primary_10_2147_DDDT_S422770 crossref_primary_10_1364_BOE_388089 crossref_primary_10_3390_jfb5040288 crossref_primary_10_1038_s42003_020_01262_z crossref_primary_10_1097_MJT_0000000000000578 crossref_primary_10_3389_fphar_2021_652716 crossref_primary_10_1016_j_jss_2015_04_077 |
Cites_doi | 10.1097/00045391-200209000-00011 10.1213/01.ANE.0000136477.46472.EB 10.1093/bja/87.2.246 10.2174/138945006778559193 10.1053/j.jvca.2007.02.016 10.1046/j.1365-2796.2003.01152.x 10.1213/01.ANE.0000143337.05366.CD 10.1097/00000539-200204000-00006 |
ContentType | Journal Article |
Copyright | Elsevier Inc. 2009 Elsevier Inc. |
Copyright_xml | – notice: Elsevier Inc. – notice: 2009 Elsevier Inc. |
DBID | CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
DOI | 10.1053/j.jvca.2008.06.006 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed CrossRef MEDLINE - Academic |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) CrossRef MEDLINE - Academic |
DatabaseTitleList | MEDLINE - Academic MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1532-8422 |
EndPage | 47 |
ExternalDocumentID | 10_1053_j_jvca_2008_06_006 18834828 S1053077008001821 1_s2_0_S1053077008001821 |
Genre | Journal Article Comparative Study |
GroupedDBID | - 0R 1 1- 1B1 1P 1RT 1~. 1~5 4.4 457 4G. 53G 5GY 5RE 5VS 7-5 71M 8P 9JM AABNK AACTN AAEDT AAIAV AAIKJ AAKOC AALMO AALRI AAOAW AAQFI AAQQT AAQXK AAXUO ABBQC ABFRF ABLVK ABMAC ABMZM ABOCM ABPIF ABQIS ABXDB ABYKQ ACDAQ ACGFO ACGFS ACRLP ADALY ADBBV ADEZE AEBSH AEFWE AEKER AENEX AEVXI AFKWA AFRHN AFTJW AFXIZ AGHFR AGUBO AGYEJ AHHHB AIEXJ AIKHN AITUG AJBFU AJOXV AJRQY AJUYK ALMA_UNASSIGNED_HOLDINGS AMFUW AMRAJ ANZVX ASPBG AVWKF AZFZN BKOJK BLXMC BNPGV CAG COF CS3 DU5 EBS EFJIC EJD EO8 EO9 EP2 EP3 F5P FDB FEDTE FGOYB FIRID FNPLU FO G- G-2 G-Q GBLVA GJ HEB HMK HMO HVGLF HZ IHE IPNFZ J1W J5H K K-O KOM LCYCR M M29 M41 MO0 N9A O-L O9- O90 OAUVE OL- OZT P-8 P-9 P2P PC. Q38 R2- RIG ROL RPZ SAE SCC SDF SDG SDP SEL SES SEW SJN SPCBC SSH SSZ T5K UHS UNMZH UV1 WUQ Z5R ZA5 --- --K --M .1- .FO .GJ .~1 0R~ 1P~ 8P~ AAEDW ABJNI ADMUD AXJTR EFLBG FYGXN HZ~ ~G- AAXKI AFCTW AFJKZ AKRWK CGR CUY CVF ECM EIF NPM AAYXX CITATION 7X8 |
ID | FETCH-LOGICAL-c410t-20f75e13453fba29856177e744e6dd5af3c5b81cd62f40760f2db5df447d20fc3 |
IEDL.DBID | AIKHN |
ISSN | 1053-0770 |
IngestDate | Sat Aug 17 03:59:48 EDT 2024 Thu Sep 26 18:07:26 EDT 2024 Sat Sep 28 07:46:03 EDT 2024 Fri Feb 23 02:34:49 EST 2024 Thu Aug 18 17:13:15 EDT 2022 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 1 |
Keywords | methemoglobin Oxyglobin hemoglobin-based oxygen carrier coagulation thromboelastography HBOC-200 |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c410t-20f75e13453fba29856177e744e6dd5af3c5b81cd62f40760f2db5df447d20fc3 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
PMID | 18834828 |
PQID | 733917980 |
PQPubID | 23479 |
PageCount | 7 |
ParticipantIDs | proquest_miscellaneous_733917980 crossref_primary_10_1053_j_jvca_2008_06_006 pubmed_primary_18834828 elsevier_sciencedirect_doi_10_1053_j_jvca_2008_06_006 elsevier_clinicalkeyesjournals_1_s2_0_S1053077008001821 |
PublicationCentury | 2000 |
PublicationDate | 2009-02-01 |
PublicationDateYYYYMMDD | 2009-02-01 |
PublicationDate_xml | – month: 02 year: 2009 text: 2009-02-01 day: 01 |
PublicationDecade | 2000 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Journal of cardiothoracic and vascular anesthesia |
PublicationTitleAlternate | J Cardiothorac Vasc Anesth |
PublicationYear | 2009 |
Publisher | Elsevier Inc |
Publisher_xml | – name: Elsevier Inc |
References | Jahr, Lurie, Gosselin (bib8) 2002; 9 Iselin, Willimann, Seifert (bib7) 2001; 87 Sprung, Kindscher, Wahr (bib4) 2002; 94 (bib1) 2005 Jahr, Weeks, Desai (bib5) 2008; 22 James, Potgieter, Ellis (bib9) 2004; 99 Essex, Li (bib3) 2006; 7 Osgood, Jahr, Desai (bib6) 2005; 100 Yeh, Alayash (bib2) 2003; 258 Jahr (10.1053/j.jvca.2008.06.006_bib8) 2002; 9 (10.1053/j.jvca.2008.06.006_bib1) 2005 Osgood (10.1053/j.jvca.2008.06.006_bib6) 2005; 100 James (10.1053/j.jvca.2008.06.006_bib9) 2004; 99 Yeh (10.1053/j.jvca.2008.06.006_bib2) 2003; 258 Iselin (10.1053/j.jvca.2008.06.006_bib7) 2001; 87 Sprung (10.1053/j.jvca.2008.06.006_bib4) 2002; 94 Essex (10.1053/j.jvca.2008.06.006_bib3) 2006; 7 Jahr (10.1053/j.jvca.2008.06.006_bib5) 2008; 22 |
References_xml | – volume: 99 start-page: 1593 year: 2004 end-page: 1597 ident: bib9 article-title: The effect of Hemopure® on coagulation in clinically relevant concentrations publication-title: Anesth Analg contributor: fullname: Ellis – volume: 9 start-page: 431 year: 2002 end-page: 436 ident: bib8 article-title: Effects of Hemoglobin-250 (Bovine) (HBOC-201, Hemopure) on coagulation testing publication-title: Am J Ther contributor: fullname: Gosselin – start-page: 178 year: 2005 ident: bib1 article-title: TEG 5000 User's Manual – volume: 22 start-page: 34 year: 2008 end-page: 39 ident: bib5 article-title: Does Oxyvita, a new generation hemoglobin-based oxygen carrier, or Oxyglobin acutely interfere with coagulation compared with normal saline or 6% Hetastarch? publication-title: J Cardiothorac Vasc Anesth contributor: fullname: Desai – volume: 87 start-page: 246 year: 2001 end-page: 249 ident: bib7 article-title: Isolated reduction of haematocrit does not compromise in vitro blood coagulation publication-title: Br J Anaesth contributor: fullname: Seifert – volume: 100 start-page: 437 year: 2005 end-page: 439 ident: bib6 article-title: Does methemoglobin from oxidized hemoglobin-based oxygen carrier (Hemoglobin Glutamer-200) interfere with lactate measurement (YSI 2700 SELECT™ Biochemistry Analyzer) publication-title: Anesth Analg contributor: fullname: Desai – volume: 258 start-page: 518 year: 2003 end-page: 526 ident: bib2 article-title: Redox side reactions of haemoglobin and cell signaling mechanisms publication-title: J Int Med contributor: fullname: Alayash – volume: 7 start-page: 1233 year: 2006 end-page: 1241 ident: bib3 article-title: Redox modification of platelet glycoproteins publication-title: Current Drug Targets contributor: fullname: Li – volume: 94 start-page: 799 year: 2002 end-page: 808 ident: bib4 article-title: The use of Bovine Hemoglobin Glutamer-250 (Hemopure®) in surgical patients: Results of a muticenter, randomized, single-blinded trial publication-title: Anesth Analg contributor: fullname: Wahr – volume: 9 start-page: 431 year: 2002 ident: 10.1053/j.jvca.2008.06.006_bib8 article-title: Effects of Hemoglobin-250 (Bovine) (HBOC-201, Hemopure) on coagulation testing publication-title: Am J Ther doi: 10.1097/00045391-200209000-00011 contributor: fullname: Jahr – volume: 99 start-page: 1593 year: 2004 ident: 10.1053/j.jvca.2008.06.006_bib9 article-title: The effect of Hemopure® on coagulation in clinically relevant concentrations publication-title: Anesth Analg doi: 10.1213/01.ANE.0000136477.46472.EB contributor: fullname: James – volume: 87 start-page: 246 year: 2001 ident: 10.1053/j.jvca.2008.06.006_bib7 article-title: Isolated reduction of haematocrit does not compromise in vitro blood coagulation publication-title: Br J Anaesth doi: 10.1093/bja/87.2.246 contributor: fullname: Iselin – volume: 7 start-page: 1233 year: 2006 ident: 10.1053/j.jvca.2008.06.006_bib3 article-title: Redox modification of platelet glycoproteins publication-title: Current Drug Targets doi: 10.2174/138945006778559193 contributor: fullname: Essex – volume: 22 start-page: 34 year: 2008 ident: 10.1053/j.jvca.2008.06.006_bib5 article-title: Does Oxyvita, a new generation hemoglobin-based oxygen carrier, or Oxyglobin acutely interfere with coagulation compared with normal saline or 6% Hetastarch? publication-title: J Cardiothorac Vasc Anesth doi: 10.1053/j.jvca.2007.02.016 contributor: fullname: Jahr – volume: 258 start-page: 518 year: 2003 ident: 10.1053/j.jvca.2008.06.006_bib2 article-title: Redox side reactions of haemoglobin and cell signaling mechanisms publication-title: J Int Med doi: 10.1046/j.1365-2796.2003.01152.x contributor: fullname: Yeh – volume: 100 start-page: 437 year: 2005 ident: 10.1053/j.jvca.2008.06.006_bib6 article-title: Does methemoglobin from oxidized hemoglobin-based oxygen carrier (Hemoglobin Glutamer-200) interfere with lactate measurement (YSI 2700 SELECT™ Biochemistry Analyzer) publication-title: Anesth Analg doi: 10.1213/01.ANE.0000143337.05366.CD contributor: fullname: Osgood – start-page: 178 year: 2005 ident: 10.1053/j.jvca.2008.06.006_bib1 article-title: TEG 5000 User's Manual – volume: 94 start-page: 799 year: 2002 ident: 10.1053/j.jvca.2008.06.006_bib4 article-title: The use of Bovine Hemoglobin Glutamer-250 (Hemopure®) in surgical patients: Results of a muticenter, randomized, single-blinded trial publication-title: Anesth Analg doi: 10.1097/00000539-200204000-00006 contributor: fullname: Sprung |
SSID | ssj0011557 |
Score | 1.9595112 |
Snippet | Objectives Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which... Because oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which may have... OBJECTIVESBecause oxidation affects platelet and coagulation factors, hemoglobin auto-oxidation in HBOCs results in the transformation to methemoglobin, which... |
SourceID | proquest crossref pubmed elsevier |
SourceType | Aggregation Database Index Database Publisher |
StartPage | 41 |
SubjectTerms | Anesthesia & Perioperative Care Blood Coagulation - drug effects Blood Coagulation - physiology coagulation Critical Care Dose-Response Relationship, Drug Drug Combinations HBOC-200 hemoglobin-based oxygen carrier Hemoglobins - pharmacology Humans methemoglobin Methemoglobin - physiology Oxyglobin Thrombelastography - methods thromboelastography |
Title | Methemoglobin Effects on Coagulation: A Dose-Response Study With HBOC-200 (Oxyglobin) in a Thrombelastogram Model |
URI | https://www.clinicalkey.es/playcontent/1-s2.0-S1053077008001821 https://dx.doi.org/10.1053/j.jvca.2008.06.006 https://www.ncbi.nlm.nih.gov/pubmed/18834828 https://search.proquest.com/docview/733917980 |
Volume | 23 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3PT9VAEJ7gIyFcjArqUyR78CAx5bXd3W7h9nxKnhogUYjcNvtTHpEWaTFy8W93tt1ijIGDxzbdbTs7O_Nt5psZgJeFYNb6nCal0TRhjKaJKq1OfJo56k1A-F21z4Nifsw-nPCTJZgNuTCBVhltf2_TO2sd70yiNCcXi8XkMyIDVFDRYR5EyXgEWkZ3xNgIlqfvP84PboIJ6DK7Hiv4fBIGxNwZvJycbZ_9MCpSKkNYorjNP92GPzs_tPcA7kcASab9Nz6EJVc9gpX9GCJfg-_7IYX3vA6VPhYV6asTN6SuyKxWX2Ozrl0yJW_rxiWfeoqsI4FPeE2-LNpTMn9zOAtqTV4d_rzup9kiOJUiR6eX9bl2CLjbjtVFQie1b-twvPfuaDZPYl-FxLAsbXEGL7jLKOPUa5XvlIihhHCCMVdYy5WnhusyM7bIPQuRO59bza1nTFgca-hjGFV15Z4CMcY6pT0VVqDsQ3FSnRdCF1blpeU2H8PrQZryoi-fIbuwN6d47Aiyj30wA7muGIMYBC6HxFA0Za6J-6qRmWxymcp_1n4M_GbkX-oj0TPc-UYyrKvEfRWCJapy9VUjBaU7oZhbOoYn_Xr_-YGyDCWBymf_-dLnsNrHpAIpZgNG7eWVe4HQptWbcG_7V7YZFfg3rT71uw |
link.rule.ids | 315,786,790,4521,24144,27955,27956,45618,45712 |
linkProvider | Elsevier |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB5VRQIuiPLq0gI-cAChdJPYjlNuZaFaoNtKsBW9WX7SrWjSNmlFL_z2ehKnCKFy4JjIj2Q8Hn_WfDMD8LIQzFqf06Q0miaM0TRRpdWJTzNHvUGE32X73C2m--zTAT9YgskQC4O0ymj7e5veWev4ZhylOT5ZLMZfAzIICio6zBNQcrgC3UI0gLyujV_XPI-AeLp0n9g6weYxciY8jo82ji6MioRKdEoUN51ON6HP7hTavg_3InwkW_0XrsCSqx7A7Vl0kD-E0xkG8B7XmOdjUZE-N3FD6opMavU9lup6S7bI-7pxyZeeIOsIsgkvybdFe0im7_YmqNTk1d7Py36Y1yQMpcj88Kw-1i7A7bbjdBGso_bjEexvf5hPpkmsqpAYlqVtGMEL7jLKOPVa5ZtlkJkQTjDmCmu58tRwXWbGFrln6LfzudXcesaEDX0NfQzLVV25VSDGWKe0p8KKAAQwNanOC6ELq_LScpuP4M0gTXnSJ8-QndOb03DpQNnHKphIrStGIAaByyEsNBgy18Rd1chMNrlM5V8rPwJ-3fMP5ZHhXPjnjGRYVxl2FbpKVOXq80YKSjcxlVs6gif9ev_-gbLEhEDl0_-c9AXcmc5nO3Ln4-7nNbjbe6eQHrMOy-3ZuXsWQE6rn3dKfAXZSfaQ |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Methemoglobin+Effects+on+Coagulation%3A+A+Dose-Response+Study+With+HBOC-200+%28Oxyglobin%29+in+a+Thrombelastogram+Model&rft.jtitle=Journal+of+cardiothoracic+and+vascular+anesthesia&rft.au=Moallempour%2C+Mojgan&rft.au=Jahr%2C+Jonathan+S.&rft.au=Lim%2C+Jennifer+C.&rft.au=Weeks%2C+David&rft.date=2009-02-01&rft.pub=Elsevier+Inc&rft.issn=1053-0770&rft.eissn=1532-8422&rft.volume=23&rft.issue=1&rft.spage=41&rft.epage=47&rft_id=info:doi/10.1053%2Fj.jvca.2008.06.006&rft.externalDocID=S1053077008001821 |
thumbnail_m | http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=https%3A%2F%2Fcdn.clinicalkey.com%2Fck-thumbnails%2F10530770%2FS1053077008X00084%2Fcov150h.gif |