ヘモグロビングルタマー200（ウシ由来）
**ヘモグロビングルタマー200（ウシ由来）** は、獣医療において主に酸素運搬輸液および強力なコロイドとして使用される、半合成の重合ウシヘモグロビン製品です。 * **主な適応症**：全血や濃厚赤血球が入手できない場合、または交差適合試験で適切なドナーが見つからない場合の貧血（溶血、失血、または無効造血による）の治療。 * **臨床的ポイント**：再生性貧血や緊急のトラウマ（外傷）状況で特に有用です。ストロマフリーであり赤血球膜を持たないため、投与前の血液型判定や交差適合試験は不要です。 * **適応外使用**：猫や、新生仔同種免疫性溶血性貧血の仔馬にも使用されていますが、強力なコロイド特性があるため極めて慎重な投与が求められます。
作用機序: 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.
動物種別の用量
- 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
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Advanced cardiac disease (e.g., congestive heart failure)
- Severely impaired cardiac function
- Renal impairment with oliguria or anuria
有害事象
- 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
モニタリング
- 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)
過量投与
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).
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。