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James K. Wright, MD; William Ehler, DVM; David L. McGlasson, MS; William Thompson, MA

Arch Surg. 2002;137:850-853.

Background  Hyperbaric oxygen (HBO) has been used for more than 25 years as therapy for extreme blood loss in cases where transfusion has been unavailable. The use of HBO for lesser amounts of blood loss to avoid the transfusion of blood products has not been investigated.

Hypothesis  Hyperbaric oxygen up-regulates hemoglobin synthesis after acute blood loss in an animal model of moderate (30%) blood loss.

Design  Twenty-four New Zealand white rabbits were bled to a calculated loss of 30% of the circulating blood volume. The rabbits received Ringer lactate infusions to correct hypovolemia and were divided into 2 groups: a control group and a treatment group receiving HBO.

Intervention  One group of 12 animals received no treatment other than Ringer lactate resuscitation, whereas the other group of 12 received 5 HBO treatments in the 4 days immediately following blood loss. Hemoglobin levels and reticulocyte counts were monitored for 14 days after the bleeding episode.

Results  The control group was more affected by the blood withdrawal than the HBO group, reaching a low of 37% hemoglobin loss compared with 29% hemoglobin loss at 48 hours (P<.001). The HBO group recovered faster, reaching the baseline level of hemoglobin in 11 days as opposed to 14 days for the control group (P<.001). Reticulocyte counts were not significantly affected by HBO treatment.

Conclusions  Treatment with HBO favorably affected recovery from moderate (30%) acute blood loss, resulting in lessened effects at 48 hours and hastening recovery to baseline hemoglobin levels. Our results support the data gained from clinical experience treating extreme blood loss with HBO.

From the Davis Hyperbaric Laboratory, US Air Force School of Aerospace Medicine, Brooks Air Force Base, Tex (Dr Wright and Mr Thompson), and the 59th Clinical Research Squadron, Wilford Hall Medical Center, Lackland Air Force Base, Tex (Dr Ehler and Mr McGlasson).

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