Holy Cow! (“I’m Bloodless”)
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).
KeywordsBloodless 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
- 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
- 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.
- Simoni J, Simoni G, Moeller JF. Intrinsic toxicity of hemoglobin: how to counter act it. ArtificialOrgans. 2009;33(2):100–9.Google Scholar