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Balancing potential risks and benefits of hemoglobin‐based oxygen carriers
Author(s) -
Weiskopf Richard B.,
Silverman Toby A.
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12339
Subject(s) - unavailability , medicine , hemoglobin , anemia , adverse effect , intensive care medicine , blood transfusion , anesthesia , surgery , engineering , reliability engineering
Hemoglobin‐based oxygen carriers ( HBOCs ) are thought to have an adverse risk:benefit profile when compared to that of transfusing stored red blood cells ( RBCs ). However, there are clinical circumstances when RBC transfusion is not an option (e.g., patient refusal, unavailability owing to issues of compatibility or remote location). For these circumstances assessment of the risks of an HBOC should be compared to the risks of untransfused acute anemia. In this article we compare the risk of allowing a patient with severe anemia to have a further small decrease in hemoglobin (Hb) concentration to the risk of infusing an HBOC . We conclude that at Hb concentrations less than 6 g/ dL , the risk of a further decrease in Hb concentration greatly exceeds the risk of HBOC infusion. Thus, we suggest that there may be a place for use of HBOCs when RBC transfusion is not an option.