Hemoglobin solutions: use in surgical patients

Excerpt

Hemoglobin-based oxygen carriers (HBOCs) are solutions that can match the oxygen-carrying capacity of red blood cells (RBCs), and several HBOCs have reached advanced stages of development and clinical testing. One of the potential mechanisms by which HBOC solutions may be effective in reducing transfused blood may be a result of the fact that in hemorrhagic conditions, replenishing lost iron is difficult. Although the oxygen-carrying capacity of most HBOC solutions may be quite transient, they are rapidly metabolized, and free iron is potentially scavenged by multiple mechanisms to subsequently stimulate erythropoiesis and reticulocytosis. Unfortunately, diaspirin-linked HBOC solutions reported a higher mortality in trauma patients. Regrettably, the trauma patient population is a heterogeneous group of patients and, similar to therapeutic trials in sepsis, trauma patients represent a group with an extremely high morbidity and mortality incidence that can potentially complicate interpreting data. …