To assess O2 delivery to tissue by a new surface-modified, polyethylene glycol-conjugated human hemoglobin [MP4; PO2 at 50% saturation of hemoglobin (P50); 5.4 mmHg], we studied microcirculatory hemodynamics and O2 release in golden Syrian hamsters hemodiluted with MP4 or polymerized bovine hemoglobin (PolyBvHb; P50 54.2 mmHg). Comparisons were made with the animals' hemodiluted blood with a non-O2 carrying plasma expander with similar solution properties (Dextran-70). Systemic hemodynamics (arterial blood pressure and heart rate) and acid-base parameters were not correlated with microhemodynamics (arteriolar and venular diameter, red blood cell velocity, and flow). Microscopic measurements of PO2 and the O2 equilibrium curves permitted analysis of O2 release in precapillary and capillary vessels by red blood cells and plasma hemoglobin separately. No significant differences between the groups of animals with respect to arteriolar diameter, flow, or flow velocity were observed, but the functional capillary density was significantly higher in the MP4-treated animals (67%) compared with PolyBvHbtreated animals (37%; P Ͻ 0.05) or dextran-treated animals (53%). In the PolyBvHb-treated animals, predominant O2 release (both red blood cells and plasma hemoglobin) occurred in precapillary vessels, whereas in MP4 animals most of the O2 was released from both red blood cells and plasma hemoglobin in capillaries. Base excess correlated directly with capillary O2 release but not systemic O2 content or total O2 release. Higher O2 extraction of both red blood cell and plasma hemoglobin in capillaries represents a new mechanism of action of cell-free hemoglobin. High O2 affinity appears to be an important property for cell-free hemoglobin solutions. blood substitutes; microcirculation; polyethylene glycol ARTERIOLAR VASOCONSTRICTION limits tissue perfusion by some early-generation hemoglobin-based O 2 carriers, increasing vascular resistance, which may be manifest as systemic hypertension, offsetting potential efficacy (40). Although the mechanism of vasoactivity has been disputed, one popular explanation is that nitric oxide (NO) is scavenged by cell-free hemoglobin (9), either directly in the lumen of the vessel or in the interstitial space after extravasation. We observed, however, that derivatized hemoglobins with different hypertensive effects have nearly identical NO binding constants (26). An alternative (or additional) mechanism is the involvement of autoregulation, by which vasoconstriction results from an oversupply of O 2 to vascular walls, particularly in arterioles, which regulate the entry of blood into capillary networks (23). An O 2 oversupply would result from facilitated diffusion of O 2 as oxyhemoglobin in plasma. Oxyhemoglobin diffusion is a function of molecular size, viscosity, and O 2 affinity, and manipulation of these three parameters offers strategies for potentially overcoming autoregulatory vasoconstriction. We explored these ideas in an artificial capillary system and concluded that the O 2 deliver...