Large volume polymerized haemoglobin solution in a Jehovah's Witness following abruptio placentae.
Severe anaemia, with haemoglobin (Hb) levels < or =3 g dL(-1), is associated with mortality rates of 50-95%. Although accepted transfusion targets have been debated in the literature (Carson et al., 2002; Practice guidelines for blood component therapy. 1996; Consensus Conference. 1988; Hebert et al., 1999), few would argue the risks associated with Hb levels less than 5 g dL(-1) in critically ill patients. In patients who are unable to receive red blood cell transfusions, the utility of Hb solutions is an attractive solution. We describe a Jehovah's Witness patient who exemplifies the marked physiologic derangements of severe anaemia and subsequent clinical resolution with large volume polymerized human Hb transfusion. The Hb-based oxygen carrier, PolyHeme, provided adequate oxygen transport, acting as a bridge until endogenous production could compensate for red cell loss. Practicing physicians need to be aware of current therapeutic options for use in these complicated patients.
Cothren
C C
CC
The Department of Surgery, Denver Health Medical Center and the University of Colorado Health Sciences Center, Denver, CO 80204, USA. clay.cothren@dhha.org
Moore
E E
EE
Long
J S
JS
Haenel
J B
JB
Johnson
J L
JL
Ciesla
D J
DJ
D000037:Abruptio Placentae / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000740:Anemia / Q000209:etiology / Q000628:therapy*; D001802:Blood Substitutes / Q000627:therapeutic use*; D004562:Electrocardiography; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006454:Hemoglobins / Q000627:therapeutic use*; D006801:Humans; D033221:Jehovah's Witnesses; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D001802:Blood Substitutes; D006454:Hemoglobins; C037158:polyhemoglobin; D004921:Erythropoietin