Amelioration of nephrotoxicity associated with synthetic oxygen transport media

Use of synthetic oxygen transport media offers the potential advantages of reducing requirements for coadministration of blood products and oxygen at the scene of mass casualty situations. Previous studies have shown perfusions of isolated kidneys with stroma-free hemoglobin (SFH) to be physiologica...

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Published inJournal of the National Medical Association Vol. 84; no. 9; pp. 773 - 777
Main Authors MILLIS, R. M, BARBER, J. D, ANDERSON, W. A, TOUSSAINT, R.-M, BAKER, F. W, HACKLEY, B. E
Format Journal Article
LanguageEnglish
Published Thorofare, NJ Slack 01.09.1992
National Medical Association
Subjects
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Biological and medical sciences
Blood Substitutes - toxicity
Fluorocarbons - toxicity
Glomerular Filtration Rate - drug effects
Hemoglobins - toxicity
Intensive care medicine
Kidney - drug effects
Kidney Function Tests
Male
Medical sciences
Perfusion
Plasma Substitutes - toxicity
Rats
Rats, Sprague-Dawley
Treatment
Transfusion
Animal
Hemoglobin
Experimental study
Resuscitation
Kidney
Isolated organ
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Summary:Use of synthetic oxygen transport media offers the potential advantages of reducing requirements for coadministration of blood products and oxygen at the scene of mass casualty situations. Previous studies have shown perfusions of isolated kidneys with stroma-free hemoglobin (SFH) to be physiological while those with Fluosol-DA (20% FDA) have been associated with low glomerular filtration rate, urinary flow rate, and fractional reabsorption of sodium and potassium (FrNa+ and FrK+). In the present studies, perfusions with SFH/FDA mixtures showed normal glomerular filtration rate, a 50% lower urinary flow rate, and FrNa+ values 3% to 5% higher than SFH controls. Compared with 20% FDA perfusions, nephrotoxic effects of SFH/FDA combinations were moderate. Compared with SFH/FDA mixtures, perfusion with 20% FDA showed lower urinary flow and glomerular filtration rates. Ultrastructural assessment of glomerular filter revealed that FDA emulsion particles were adherent to epithelial podocytes. We conclude that resuscitation with a mixture of SFH and FDA may ameliorate the previously reported nephrotoxicity associated with the use of FDA alone.
ISSN:0027-9684
1943-4693