Use of a hemoglobin-based oxygen carrier in the treatment of severe anemia.
BACKGROUND
Hemoglobin-based oxygen carriers hold promise for the treatment of acute anemia.


METHODS
We report a patient with severe dysfunctional uterine bleeding. During her hospitalization, her lowest hemoglobin level was 3.1 g/dL, with a hematocrit of 9.3%. An investigational product, o-raffinose cross-linked human hemoglobin solution (hemoglobin raffimer), was infused along with ongoing high-dose recombinant human erythropoietin and estrogen. The time until the patient's own hematopoiesis provided sufficient red blood cell mass was successfully managed by reducing oxygen demand and providing multiple hemoglobin-based oxygen carrier infusions. After hemoglobin-based oxygen carrier administration, transient pulmonary hypertension and fever were noted. She was discharged after corrective surgery 7 days after hemoglobin-based oxygen carrier administration with a hemoglobin level of 7.8 g/dL.


CONCLUSIONS
The hemoglobin level-based oxygen carrier improved oxygen delivery and permitted uterine corrective surgery.
Shander
Aryeh
A
Department of Anesthesiology and Critical Care Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey 07631, USA. aryeh.shander@ehmc.com
Alalawi
Raed
R
Seeber
Petra
P
Lui
John
J
D000328:Adult; D000740:Anemia / Q000209:etiology / Q000628:therapy*; D004630:Emergencies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D033221:Jehovah's Witnesses; D008595:Menorrhagia / Q000150:complications*; D011887:Raffinose / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D006454:Hemoglobins; C097124:O-raffinose cross-linked human hemoglobin; D011887:Raffinose