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Use of a Hemoglobin-Based Oxygen Carrier in the Treatment of Severe Anemia

Shander, Aryeh MD*; Alalawi, Raed MD†; Seeber, Petra MD‡; Lui, John MD*

Case Reports

BACKGROUND: Hemoglobin-based oxygen carriers hold promise for the treatment of acute anemia.

CASE: 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.

CONCLUSION: The hemoglobin level–based oxygen carrier improved oxygen delivery and permitted uterine corrective surgery.

A hemoglobin-based artificial oxygen carrier restored oxygen delivery in a severely anemic patient (lowest hemoglobin level of 3.1 g/dl) with severe uterine bleeding.

*Department of Anesthesiology and Critical Care Medicine and †Department of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey; and ‡Department of Anesthesiology and Intensive Care, Freidrich Schiller University, Jena, Germany

Dr. Shander was a Principal Investigator on HLK-213, an investigational trial in cardiac surgery patients, for which he received compensation for patients who completed the protocol.

Address reprint requests to: Aryeh Shander, MD, Department of Anesthesiology and Critical Care Medicine, Englewood Hospital and Medical Center, 350 Engle Street, Englewood, NJ 07631; e-mail: aryeh.shander@ehmc.com

Received June 24, 2003. Received in revised form September 18, 2003. Accepted October 15, 2003.

© 2004 The American College of Obstetricians and Gynecologists