Comparison of Hb-200 and 6% hetastarch 450/0.7 during initial fluid resuscitation of 20 dogs with gastric dilatation-volvulus

Authors

  • Carol E. Haak DVM,

    Corresponding author
    • Animal Emergency Center and Specialty Services, Glendale, WI
    Search for more papers by this author
  • Elke Rudloff DVM, DACVECC,

  • Rebecca Kirby DVM, DACVIM, DACVECC


  • Presented in abstract form at International Veterinary Emergency and Critical Care Symposium, Orlando, FL, 2000.

  • The Oxyglobin used in this study was donated by Biopure Corporation, Cambridge, MA.

Address correspondence and reprint requests to Dr. Carol E. Haak, Animal Emergency Center and Specialty Services, 2100 W. Silver Spring Drive, Glendale, WI 53209, USA. Email: caraol.haak@gmail.com

Abstract

Objective

To compare the use of polymerized stroma-free bovine hemoglobin (Hb-200) and 6% hetastarch 450/0.7 (HES 450/0.7) in 0.9% saline during fluid resuscitation of dogs with gastric dilatation-volvulus (GDV).

Design

Prospective, randomized clinical case series.

Setting

Private specialty and referral clinic.

Animals

Twenty client-owned dogs presenting with GDV.

Interventions

Dogs presenting with GDV and abnormal perfusion parameters first received rapid IV infusion of a buffered isotonic replacement crystalloid (15 mL/kg) and IV opioids. Patients were then randomized to receive either Hb-200 (N = 10) or HES 450/0.7 (N = 10). Balanced isotonic replacement crystalloids (10–20 mL/kg IV) were rapidly infused along with either Hb-200 or HES in 5 mL/kg IV aliquots to meet resuscitation end points.

Measurements and Main Results

Resuscitation was defined as meeting at least 2 of 3 criteria: (1) capillary refill time 1–2 seconds, pink mucous membrane color, strong femoral pulse quality; (2) heart rate (HR) ≤ 150/min; or (3) indirect arterial systolic blood pressure (SBP) > 90 mm Hg. HR, SBP, packed cell volume, hemoglobin, glucose, venous pH, bicarbonate, base excess, anion gap, and colloid osmotic pressure were compared at hospital entry and within 30 minutes post-resuscitation. Compared to the HES group, the Hb-200 group required significantly less colloid (4.2 versus 18.4 mL/kg) and crystalloid (31.3 versus 48.1 mL/kg) to reach resuscitation end points (P = 0.001). Time to resuscitation was significantly shorter in the Hb-200 group (12.5 versus 52.5 min).

Conclusions

Dogs with GDV receiving Hb-200 during initial resuscitation required smaller volumes of both crystalloid and colloid fluids and reached resuscitation end points faster than dogs receiving HES 450/0.7 (P = 0.02).

Ancillary