Hypotension Clinical Trial
Official title:
A Clinical Safety (Phase Ib/II) Increasing Dose Study of MP4 (Hemospan) in Orthopedic Surgery Patients
The purpose of this study is to evaluate the safety and possible effectiveness of Hemospan solution in patients undergoing elective orthopedic surgery who receive spinal anesthesia.
Allogeneic (donor) blood transfusions are often required during and/or after orthopedic hip
surgery to maintain adequate hemoglobin concentration, prevent tissue ischemia, treat
hypotension, and compensate for fluid shifts. For example, during hospitalization for hip
replacement, patients may receive up to two to three units of blood. This amount varies
depending on the technical difficulty of the surgery, the patient's hemoglobin concentration
prior to surgery, and the patient's clinical status.
The limited availability, logistic constraints and documented risks associated with
allogeneic blood transfusions have prompted the search for alternative therapies. Autologous
(self-donated) red blood cell pre-donation can be used in many cases but age, anemia and
co-morbidities often preclude the use of this treatment. Cell saving and re-infusion also
prevents blood transfusion, but this practice also has potential problems and limited
applicability.
Over the past 75 years various "blood substitutes" have been developed for potential
clinical use. To date all have shown significant toxicity in preclinical or clinical studies
and regulatory approval of these synthetic or hemoglobin-based products has been impeded by
safety concerns.
Hemospan is a novel polyethylene-modified hemoglobin solution specifically developed to
perfuse and oxygenate tissue at risk for ischemia and hypoxia. As a result of the molecular
size and oxygen dissociation characteristics, Hemospan selectively off-loads oxygen in
tissues predisposed to low oxygen tension. In preclinical studies Hemospan has been found to
be free of significant toxicity in a variety of animal species in doses exceeding those that
will be used in this study.
In the Phase I safety study in normal volunteers, Hemospan was well tolerated in doses up to
100 mg/kg (approximately 200 mL of a 4g/dL Hemospan solution).
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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