Evidence map›Paper›PMID 33510204›Full record

ArticleScientific reports2021

Resuscitation from hemorrhagic shock after traumatic brain injury with polymerized hemoglobin.

Cynthia R Muller, Vasiliki Courelli, Alfredo Lucas, Alexander T Williams, Joyce B Li, Fernando Dos Santos, Clayton T Cuddington, Savannah R Moses, Andre F Palmer, Erik B Kistler and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 31 citations in OpenAlex.

  1. Hemoglobin-based oxygen carriers with antioxidant properties.Journal of materials chemistry. B · 2026
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  2. Review
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  7. The influence of hemorrhagic shock on brain perfusion in a swine model of raised intracranial pressure.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  8. Article
  9. Article
  10. Article
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  12. Polymerized human hemoglobin with low and high oxygen affinity in trauma models.Translational research : the journal of laboratory and clinical medicine · 2023
    Article
  13. Article
  14. Article
  15. Article
  16. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Cynthia R MullerDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA.
Vasiliki CourelliDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA.
Alfredo LucasDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA.
Alexander T WilliamsDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA.
Joyce B LiDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA.
Fernando Dos SantosDepartment of Anesthesiology and Critical Care, University of California San Diego, San Diego, CA, USA.
Clayton T CuddingtonWilliam G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.
Savannah R MosesWilliam G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.
Andre F PalmerWilliam G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.
Erik B KistlerDepartment of Anesthesiology and Critical Care, University of California San Diego, San Diego, CA, USA.
Pedro CabralesDepartment of Bioengineering, University of California San Diego, 9500 Gilman Dr. La Jolla, San Diego, CA, 92093-0412, USA. pcabrales@ucsd.edu.
University of California, San Diego · USThe Ohio State University · US

Funding

Integrative Bioengineering of Heart, Vessels, and BloodT32HL105373 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CHIEN, SHU, INTAGLIETTA, MARCOS · 2010 to 2019
$3.6M
PEGylated megahemoglobin for use as a red blood cell substituteR01HL138116 · NHLBI · OHIO STATE UNIVERSITY · PI CABRALES, PEDRO, KAUMAYA, PRAVIN T. P. · 2017 to 2020
$2.9M
Attenuating the Oxidative and Myocardial Side-Effects of Acellular HemoglobinR01HL126945 · NHLBI · OHIO STATE UNIVERSITY · PI CABRALES, PEDRO, PALMER, ANDRE FRANCIS · 2016 to 2019
$1.7M
Polymerized Hemoglobins for Facilitated Oxygen Transport in Hepatic BioreactorsR01EB021926 · NIBIB · OHIO STATE UNIVERSITY · PI BERTHIAUME, FRANCOIS, PALMER, ANDRE FRANCIS · 2016 to 2019
$1.4M
NHLBI NIH HHS R01 HL126945NHLBI NIH HHS R01 HL138116NHLBI NIH HHS T32 HL105373NIBIB NIH HHS R01 EB021926
6 · The paper itself

Abstract

Traumatic brain injury (TBI) is often accompanied by hemorrhage, and treatment of hemorrhagic shock (HS) after TBI is particularly challenging because the two therapeutic treatment strategies for TBI and HS often conflict. Ischemia/reperfusion injury from HS resuscitation can be exaggerated by TBI-induced loss of autoregulation. In HS resuscitation, the goal is to restore lost blood volume, while in the treatment of TBI the priority is focused on maintenance of adequate cerebral perfusion pressure and avoidance of secondary bleeding. In this study, we investigate the responses to resuscitation from severe HS after TBI in rats, using fresh blood, polymerized human hemoglobin (PolyhHb), and lactated Ringer's (LR). Rats were subjected to TBI by pneumatic controlled cortical impact. Shortly after TBI, HS was induced by blood withdrawal to reduce mean arterial pressure (MAP) to 35-40 mmHg for 90 min before resuscitation. Resuscitation fluids were delivered to restore MAP to ~ 65 mmHg and animals were monitored for 120 min. Increased systolic blood pressure variability (SBPV) confirmed TBI-induced loss of autoregulation. MAP after resuscitation was significantly higher in the blood and PolyhHb groups compared to the LR group. Furthermore, blood and PolyhHb restored diastolic pressure, while this remained depressed for the LR group, indicating a loss of vascular tone. Lactate increased in all groups during HS, and only returned to baseline level in the blood reperfused group. The PolyhHb group possessed lower SBPV compared to LR and blood groups. Finally, sympathetic nervous system (SNS) modulation was higher for the LR group and lower for the PolyhHb group compared to the blood group after reperfusion. In conclusion, our results suggest that PolyhHb could be an alternative to blood for resuscitation from HS after TBI when blood is not available, assuming additional testing demonstrate similar favorable results. PolyhHb restored hemodynamics and oxygen delivery, without the logistical constraints of refrigerated blood.

Indexed as

AnimalsBiomarkersBlood Gas AnalysisBlood PressureBlood VolumeBrain Injuries, TraumaticDisease Models, AnimalHemodynamicsHemoglobinsHumansHydrocortisoneMaleRatsResuscitationShock, HemorrhagicBiomarkershemoglobin polymerHemoglobinsHydrocortisone

Identifiers

PMID33510204
PMCPMC7843604
OpenAlexW3124886998

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.