resuscitation in small animals - Maravet

36 Shock
Often the infusion of a synthetic colloid in the fluid therapy program allows a reduction in the
crystalloid fluid requirement by 40-60%.
43. What is oxyglobin? When is it used in a shock patient?
Oxyglobin is a member of a group of compounds know as hemoglobin-based oxygen carriers
(HBOC). The molecule is polymer of bovine hemoglobin that recently was approved for use
in dogs in the United States. The HBOCs have evolved from more than 50 years of research into
acelluar blood replacement solutions. The oxygen-carrying characteristics of this product are
similar to those of blood with several important differences. Oxyglobin binds and releases
oxygen more readily than whole blood, requires no typing or cross-matching, requires no special
administration set or filter, does not depend on levels of 2,3-diphosphoglycerate to regulate its
oxygen-binding site, and is shelf-stable for more than I year at room temperature. Oxyglobin has
demonstrated its effectiveness in restoring oxygen delivery in anemic dogs or dogs in hemorrhagic
shock. Recent research has demonstrated that Oxyglobin administered at low doses improves
oxygen delivery to tissues by increasing the transfer of oxygen across the interstitial fluid
barrier and by reaching tissues that red blood cells cannot. Label directions must be followed
closely. Oxyglobin has significant colloidal osmotic properties and can induce circulatory overload
if administered too rapidly or in excess of recommended dosages.
44. What is the rationale behind low-volume resuscitation in hemorrhagic shock?
The rationale is simple: administration of small volumes of fluids during traumatic or hemorrhagic
shock reduces the risk of disrupting clotted vasculature and exacerbating hemorrhage
until definitive care is available. Although this concept recently has been popularized based on
one paper, no currently available data determine how low or for how long a patient can be maintained
before irreversible shock will result. The efficacy and safety of this theory are unproved in
the clinical setting and warrant further study.
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