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Holy Cow! (“I’m Bloodless”)

  • Mark T. Friedman
  • Kamille A. West
  • Peyman Bizargity
  • Kyle Annen
  • Jeffrey S. Jhang
Chapter

Abstract

A 59-year-old female, a self-described homemaker, and a mother to three children presents to the emergency department (ED) with acute-on-chronic anemia secondary to lower gastrointestinal (GI) bleeding (the patient is known to have a history of colonic diverticular bleeding) and iron deficiency. The patient takes iron and vitamin supplements at home. She additionally takes warfarin due to a history of atrial fibrillation. The patient’s hemoglobin (Hgb) level is 6.4 g/dL in the ED, and the patient appears pale with tachycardia (heart rate 110 beats/min) though her blood pressure is stable at 130/80 mmHg and her oxygen saturation is normal (98%) on room air. A type and screen sample (ethylenediaminetetraacetic acid [EDTA] anticoagulant) is submitted to the blood bank along with a request for crossmatch of two units of red blood cells (RBCs).

Keywords

Bloodless patient Blood substitute Bovine hemoglobin Compassionate use Expanded access Fluosol DA HemAssist Hemoglobin oxygen carrier Hemolink Hemopure Jehovah’s Witness Orphan drug Oxycyte Oxygent PEGylated bovine carboxyhemoglobin Perfluorocarbons PolyHeme SANGUINATE 

References

  1. 1.
    Spahn DR. Blood substitutes artificial oxygen carriers: perfluorocarbon emulsions. Crit Care. 1999;3(5):R93–7.CrossRefGoogle Scholar
  2. 2.
    Greenburg AG, Kim HW. Hemoglobin-based oxygen carriers. Crit Care. 2004;8(Suppl 2):S61–4.CrossRefGoogle Scholar
  3. 3.
    Abdu Alayash, (2017) Hemoglobin-based blood substitutes and the treatment of sickle cell disease: more harm than help? Bahler J, ed. Biomolecules 7(4):2.Google Scholar
  4. 4.
    Chen J-Y, Scerbo M, Kramer GA. Review of blood substitutes: examining the history, clinical trial results, and ethics of hemoglobin-based oxygen carriers. Clinics (Sao Paulo, Brazil). 2009;64(8):803–13.CrossRefGoogle Scholar
  5. 5.
    Abuchowski A. PEGylated bovine carboxyhemoglobin (SANGUINATE™): results of clinical safety testing and use in patients. Adv Expo Med Biol. 2016;876:461–7.CrossRefGoogle Scholar
  6. 6.
    Henriques C. Prolong completes enrolling patients in phase 2 trial of sickle cell disease therapy Sanguinate. In: Sickle Cell Anemia News. 21 Dec 2017. Available at: https://sicklecellanemianews.com/2017/12/21/prolong-completes-enrollment-in-phase-2-trial-of-sickle-cell-disease-therapy-sanguinate/. Accessed 14 Mar 2018.

Recommended Reading

  1. Simoni J, Simoni G, Moeller JF. Intrinsic toxicity of hemoglobin: how to counter act it. ArtificialOrgans. 2009;33(2):100–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mark T. Friedman
    • 1
  • Kamille A. West
    • 2
  • Peyman Bizargity
    • 3
  • Kyle Annen
    • 4
  • Jeffrey S. Jhang
    • 1
  1. 1.Icahn School of MedicineMount Sinai Health SystemNew YorkUSA
  2. 2.Department of Transfusion MedicineNational Institutes of Health Clinical CenterBethesdaUSA
  3. 3.Department of Molecular & Human GeneticsBaylor College of MedicineHoustonUSA
  4. 4.Department of PathologyChildren’s Hospital ColoradoAuroraUSA

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