title: Use of a hemoglobin-based oxygen carrier in the treatment of severe anemia.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey 07631, USA. aryeh.shander@ehmc.com
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
authors.forename: Raed
authors.initials: R
authors.lastname: Alalawi
authors.forename: Petra
authors.initials: P
authors.lastname: Seeber
authors.forename: John
authors.initials: J
authors.lastname: Lui
mesh_terms: 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*
chemical_list: D006454:Hemoglobins; C097124:O-raffinose cross-linked human hemoglobin; D011887:Raffinose