Hemoglobin glutamer-200 (bovine)
**Hemoglobin glutamer-200 (bovine)** is a semi-synthetic, polymerized bovine hemoglobin product used primarily as an oxygen-carrying fluid and potent colloid in veterinary medicine. * **Primary Indication**: Treatment of anemia (due to hemolysis, blood loss, or ineffective erythropoiesis) when whole blood or packed red blood cells are unavailable, or when no suitable donors are identified on crossmatch. * **Clinical Pearl**: It is particularly valuable in regenerative anemias and emergency trauma situations. Because it is stroma-free and lacks red blood cell membranes, it does not require blood typing or crossmatching prior to administration. * **Extra-label Use**: Has been used in cats and in foals for neonatal isoerythrolysis, though extreme caution is required due to its potent colloidal properties.
Mecanismo: HG-200 functions both as an oxygen carrier and a potent colloid expander: * **Oxygen Delivery**: Releases oxygen to tissues similarly to endogenous hemoglobin. It **shifts the oxygen dissociation curve to the right**, facilitating easier oxygen offloading to hypoxic tissues. * **Microvascular Perfusion**: Due to its small molecular size compared to intact RBCs, it can bypass severe arterial constrictions to oxygenate ischemic cells. * **Colloidal Effect**: Acts as a potent colloid (similar to dextran 70 or hetastarch), expanding intravascular volume by increasing oncotic pressure. * **Vascular Tone**: Causes significant **vasoconstriction**, which can increase blood pressure but may decrease cardiac output in hypovolemic states.
Dosificación por especie
- As an option to provide oxygen carrying capacity in the trauma patient · 2.5-10 mL/kg · IV · Given over several hours · Care must be taken not to cause fluid overload especially in cats.
- Labeled indications (anemia) · 10-30 mL/kg · IV · One-time dose at a rate of up to 10 mL/kg/hr · Do not administer with other fluids or drugs via the same infusion set.
- Resuscitation of trauma patients in shock with or without hemorrhage · 3-5 mL/kg · IV · Once · With concurrent crystalloid at 1/2 to 2 times maintenance.
- To provide a 'bridge' until immunosuppressive drugs take effect in dogs with IMHA with a transfusion reaction · 7-10 mL/kg or 30 mL/kg · IV · q12h (for 7-10 mL/kg dose) · 48-72 hours (for 30 mL/kg dose) · 7-10 mL/kg maintains Hb >3.5 g/dL; 30 mL/kg provides support for 48-72h.
- As an option to provide oxygen carrying capacity in the trauma patient · 10-15 mL/kg · IV · Given over several hours · Care must be taken not to cause fluid overload.
- As a vasopressor once there is adequate intravascular volume in trauma patients · 3-5 mL/kg · IV · Once
Las dosis son una referencia clínica para veterinarios colegiados. Confirme siempre con la ficha técnica vigente y el paciente individual.
Vías de administración
Contraindicaciones
- Advanced cardiac disease (e.g., congestive heart failure)
- Severely impaired cardiac function
- Renal impairment with oliguria or anuria
Efectos adversos
- Discolored mucous membranes, sclera, skin (yellow, red, brown)
- Discolored urine (orange, red, brown)
- Increased central venous pressure (CVP)
- Ventricular arrhythmias (AV block, tachycardia, VPCs)
- Vomiting, diarrhea, anorexia
- Tachypnea, dyspnea, harsh lung sounds
- Pulmonary edema and pleural effusion (due to volume overload)
- Fever
- Peripheral edema
- Hemoglobinuria
Monitorización
- Hemoglobin levels
- Clinical signs of adequate tissue oxygenation
- Central venous pressure (CVP) and signs of circulatory overload
- Respiratory rate and effort (watch for pulmonary edema)
- Heart rate and rhythm (watch for arrhythmias)
Sobredosis
Clinical signs of overdosage (1 to 3 times the recommended dose) include yellow-orange discoloration of skin, mucous membranes, and sclera; red-dark-green-black feces; brown-black urine; decreased appetite/thirst; vomiting; diarrhea; and decreased skin elasticity. Overdosage or excessively rapid administration (>10 mL/kg/hr) may result in severe circulatory overload (pulmonary edema, pleural effusion).
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.