title: Large volume polymerized haemoglobin solution in a Jehovah's Witness following abruptio placentae.
abstract: 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.
authors.affiliation: The Department of Surgery, Denver Health Medical Center and the University of Colorado Health Sciences Center, Denver, CO 80204, USA. clay.cothren@dhha.org
authors.forename: C C
authors.initials: CC
authors.lastname: Cothren
authors.forename: E E
authors.initials: EE
authors.lastname: Moore
authors.forename: J S
authors.initials: JS
authors.lastname: Long
authors.forename: J B
authors.initials: JB
authors.lastname: Haenel
authors.forename: J L
authors.initials: JL
authors.lastname: Johnson
authors.forename: D J
authors.initials: DJ
authors.lastname: Ciesla
mesh_terms: 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
chemical_list: D001802:Blood Substitutes; D006454:Hemoglobins; C037158:polyhemoglobin; D004921:Erythropoietin