A217 the Use of Diaspirin Crosslinked Hemoglobin (Dclhb) as an Alternative Transfusion in Cardiac Surgery Patients Following Cardiopulmonary Bypass

Baron, J. F.; Bemdge, J.; Brichant, Jean-François; Demeyere, Roland; Lamy, Maurice; Larbuisson, Robert; Lehot, J.-J.; Parsloe, M.; Sinclar, C.J.; Vandermeersch, E.

doi:10.1097/00000542-199709001-00217

Cited by 12 publications

(2 citation statements)

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“…Very recently, such high doses were found to be safe in patients after they underwent coronary bypass surgery. 19 In conclusion, infusion of low doses of DCLHb over 3 days adversely affected outcome in acute ischemic stroke patients, and more serious adverse events and deaths occurred. A difference in baseline stroke severity scores may have contributed to this imbalance.…”

Section: Discussionmentioning

confidence: 85%

Controlled Safety Study of a Hemoglobin-Based Oxygen Carrier, DCLHb, in Acute Ischemic Stroke

Saxena

Wijnhoud

Carton

et al. 1999

Stroke

212

132

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Background and Purpose-Diaspirin cross-linked hemoglobin (DCLHb) is a purified, cell-free human hemoglobin solution. In animal stroke models its use led to a significant reduction in the extent of brain injury. The primary objective of this study was to evaluate the safety of DCLHb in patients with acute ischemic stroke. Methods-DCLHb or saline was administered to 85 patients with acute ischemic stroke in the anterior circulation, within 18 hours of onset of symptoms, in a multicenter, randomized, single-blind, dose-finding, controlled safety trial, consisting of 3 parts: 12 doses of 25, 50, and 100 mg/kg DCLHb over 72 hours. Results-DCLHb caused a rapid rise in mean arterial blood pressure. The pressor effect was not accompanied by complications or excessive need for antihypertensive treatment. Two patients in the 100 mg/kg group had adverse events that were possibly drug related: one suffered fatal brain and pulmonary edema, the other transient renal and pancreatic insufficiency. Multivariate logistic regression analysis showed that a severe stroke at baseline and treatment with DCLHb (OR, 4.0; CI, 1.4 to 12.0) were independent predictors of a worse outcome (Rankin Scale score of 3 to 6) at 3 months. Conclusions-Outcome scale scores were worse in the DCLHb group, and more serious adverse events and deaths occurred in DCLHb-treated patients than in control patients. We recommend that additional safety studies be performed, preferably with a second generation, genetically engineered hemoglobin. (Stroke. 1999;30:993-996.)

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Section: Discussionmentioning

confidence: 85%

Controlled Safety Study of a Hemoglobin-Based Oxygen Carrier, DCLHb, in Acute Ischemic Stroke

Saxena

Wijnhoud

Carton

et al. 1999

Stroke

212

132

View full text Add to dashboard Cite

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“…In a small study [22], DCLHb (750 ml) effectively eliminated the need for any transfusions of blood for a period of 7 days in one-third (four out of 12) of patients undergoing elective hip arthroplasty with high blood loss. A larger trial in post bypass cardiac surgery patients requiring transfusion was undertaken to determine the efficacy of DCLHb in reducing or preventing the postoperative use of blood transfusions [24]. In that multicenter study, 209 patients were enrolled when it was determined that they required transfusion after bypass.…”

Section: Cross-linked Haemoglobinsmentioning

confidence: 99%