Early Clinical Trials Suggests Hydroxocobalamin Beneficial for Hemorrhagic Shock

Avoiding Shock Bebarta VS, Garrett N, Boudreau S, et al. A prospective, randomized trial of intravenous hydroxocobalamin versus whole blood transfusion compared to no treatment for class III hemorrhagic shock resuscitation in a prehospital swine model. Acad Emerg Med. 2015;22(3):321–330. Hypovolemia and shock in trauma remains one of the leading causes of death from traumatic injuries. To combat hypovolemia and hemorrhage, we've seen repeated attempts at synthetic blood replacements and certain services carrying actual blood products. Unfortunately, synthetics have had mixed results and blood itself is very difficult to stock. With that in mind, researchers from the San Antonio Military Medical Center are considering an alternative use for a medication that may already be in some of our ambulances. Hydroxocobalamin, also known as Cyanokit, was approved for use in the U.S. as a treatment for cyanide poisoning in 2007. Also a member of the vitamin B12 family, hydroxocobalamin's effect on nitric oxide (NO) has been linked to improved blood pressure in previous studies. NO is a signaling molecule in the body that can be used by the vasculature and cardiovascular system to cause vasodilation and decrease blood pressure. Hydroxocobalamin scavenges for NO in the bloodstream, leading to an increase in blood pressure and systemic vascular resistance. Study Set-up: The authors studied the effects of hydroxocobalamin in pigs with significant blood loss. Thirty swine were sedated, intu...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Special Topics Research Columns Patient Care Source Type: news