Holy Cow! (“I’m Bloodless”)

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


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).


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 


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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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