raffinose and Hypertension--Pulmonary

Hemoglobin-based oxygen carriers hold promise for the treatment of acute anemia.. We report a patient with severe dysfunctional uterine bleeding. During her hospitalization, her lowest hemoglobin level was 3.1 g/dL, with a hematocrit of 9.3%. An investigational product, o-raffinose cross-linked human hemoglobin solution (hemoglobin raffimer), was infused along with ongoing high-dose recombinant human erythropoietin and estrogen. The time until the patient's own hematopoiesis provided sufficient red blood cell mass was successfully managed by reducing oxygen demand and providing multiple hemoglobin-based oxygen carrier infusions. After hemoglobin-based oxygen carrier administration, transient pulmonary hypertension and fever were noted. She was discharged after corrective surgery 7 days after hemoglobin-based oxygen carrier administration with a hemoglobin level of 7.8 g/dL.. The hemoglobin level-based oxygen carrier improved oxygen delivery and permitted uterine corrective surgery.

Topics: Adult; Anemia; Emergencies; Female; Hematocrit; Hemoglobins; Humans; Hypertension, Pulmonary; Jehovah's Witnesses; Menorrhagia; Raffinose

Protection of the failing right ventricle (RV) in the surgical treatment of massive pulmonary embolism is a keystone for myocardial recovery. This study evaluated whether cardioplegia should be used or avoided. In a modified Langendorff rat heart model pulmonary embolism was simulated by afterload elevation (20 cm H2O) for 30 min. Hearts were arrested with cardioplegic solutions [St. Thomas Hospital (ST); University of Wisconsin (UW); oxygenated Krebs-Henseleit-Potassium (KHP)] and stored for 10 min or were allowed to beat empty (NoCP) for 15 min. After reestablishing of baseline conditions groups were measured for 60 min. Cardiac index (CI) decreased in all groups to 20% during afterload elevation. Group NoCP showed 68 and Group ST 65% recovery after 10 min and deteriorated after 30 min. After 60 min CI was 37 (ST) and 39% (NoCP). UW and KHP showed a significantly better recovery (KHP 100%; UW 88%). At 60 min CI decreased to 60 (KHP) and 64% (UW), but was still significantly higher than corresponding values of NoCP and ST. Following increased pulmonary afterload cardioplegia with UW or KHP solution is beneficial for RV recovery. The composition of the cardioplegia is obviously important and needs further study.

Topics: Acute Disease; Adenosine; Allopurinol; Animals; Cardioplegic Solutions; Disease Models, Animal; Embolectomy; Evaluation Studies as Topic; Extracorporeal Circulation; Glucose; Glutathione; Heart Arrest, Induced; Heart Failure; Hypertension, Pulmonary; Insulin; Male; Myocardial Reperfusion Injury; Organ Preservation Solutions; Pulmonary Embolism; Raffinose; Rats; Rats, Inbred Lew; Tromethamine; Ventricular Function, Right