Abstract 18674: Effects of Erythropoietin during Hemorrhagic Shock in a Swine Model
Background: Erythropoietin (EPO) has recently been shown to activate cell survival mechanisms in a broad array of organs and tissues including the heart, brain, kidney, liver, and skin. We developed a swine model of hemorrhagic shock (HS) of increasing severity to investigate whether erythropoietin - through these mechanisms - could help attenuate tissue injury and improve survival.
Methods: Two HS protocols were developed in two series of 24 male pigs each. In an initial series, 50% of the estimated blood volume (BV) was withdrawn (BW) over 30 minutes (Series-50%); in a subsequent series an additional 15% BV was withdrawn over an additional 30 minutes to a total of 65% BV removal (Series-65%). At 90 minutes, normal saline - threefold the BV withdrawn - was given over 240 minutes in both series followed by blood reinfusion (BR). Within each group, pigs were randomized to receive EPO (5,000 U/kg) or NaCl intraosseously after having withdrawn 10% of the BV.
Results: Overall survival measured at the end of BR was 87.5% in Series-50% and 25% in Series-65% with no differences between EPO and NaCl (Table). The greater HS severity in Series-65% was evidenced by a lower mean aortic pressure, development of lactic acidosis, and lower oxygen consumption (VO2) at the end of HS. However, these manifestations of increased shock severity appeared to have been attenuated by EPO (Table).
Conclusions: Despite comparable survival outcomes, the present study supports the possibility that EPO could exert beneficial hemodynamic effects under conditions of anaerobic metabolism; a possibility currently being investigated by examining whether EPO could be effective in reducing organ dysfunction in combination with therapies able to increase survival.
- © 2012 by American Heart Association, Inc.