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Obstetrics & Gynecology 2004;103:1096-1099
© 2004 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

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

Aryeh Shander, MD*, Raed Alalawi, MD{dagger}, Petra Seeber, MD{ddagger} and John Lui, MD*

*Department of Anesthesiology and Critical Care Medicine and {dagger}Department of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey; and {ddagger}Department of Anesthesiology and Intensive Care, Freidrich Schiller University, Jena, Germany

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{at}ehmc.com

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.






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