Hemoglobin solutions—Not just red blood cell substitutes

Abstract

Hemoglobin solutions are more than mere blood substitutes. Promising effects on oxygen transport and the microcirculation need to be confirmed, and the results of continuing research are eagerly awaited.

The use of a hemoglobin-based oxygen-carrying solution (HBOC-201) for extracorporeal membrane oxygenation in a porcine model with acute respiratory distress syndrome

“…HBOC-201 has been tested extensively as a low-volume oxygen delivery and trauma resuscitation medium in multiple animal models (11,13,14). In these studies, HBOC-201 has been shown to sustain tissue oxygenation.…”

“…In these studies, HBOC-201 has been shown to sustain tissue oxygenation. It is thought to preferentially increase oxygen delivery to ischemic areas (less viscous, acellular) while allowing for increased oxygen extraction at the tissue level (14). Its increased oncotic pressure (compared with blood and crystalloid) and vasopressorlike qualities make it an attractive alternative to other agents, especially in patients with hypovolemic and septic shock.…”

Arterial oxygenation and oxygen delivery after hemoglobin-based oxygen carrier infusion in canine hypovolemic shock: A dose-response study

“…HBOCs are expected to restore oxygen supply more effectively than nonoxygen carrying colloids after hemorrhagic shock (22)(23)(24)(25)(26)(27). However, there is great controversy as to whether this assumption holds true.…”

Time course of hemoglobin concentrations in nonbleeding intensive care unit patients

“…Possible alternatives to blood transfusion are being developed, including the administration of oxygen carrying solutions (5), but these are not yet commercially available. Although expensive, EPO administration has been proposed recently as an alternative to allogenic transfusion in these patients (6).…”