Amelioration of nephrotoxicity associated with synthetic oxygen transport media

• Published in: Journal 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
• Language: English
• 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
• ISSN: 0027-9684

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.