Diaspirin-Crosslinked Hemoglobin Reduces Blood Transfusion in Noncardiac Surgery: A Multicenter, Randomized, Controlled, Double-Blinded Trial

Schubert, Armin; Przybelski, Robert J.; Eidt, John F.; Lasky, Larry C.; Marks, Kenneth E.; Karafa, Matthew; Novick, Andrew C.; OʼHara, Jerome F.; Saunders, M.; Blue, John; Tetzlaff, John E.; Mascha, Edward J.

doi:10.1213/01.ane.0000068888.02977.da

Cited by 63 publications

(39 citation statements)

References 19 publications

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“…In a study with diaspirin cross-linked Hb (DCLHb, HemAssist ® , Baxter, Deerfield, IL, USA) in noncardiac surgical patients who received a maximum of 75 g Hb in three fractions within 36 h perioperatively, the percentage of nontransfused patients was 48% on postoperative day 1 and 23% on postoperative day 7. The median number of transfused allogeneic RBC units was 2 in the DCLHb and 3 in the control group [44]. However, this study was terminated early because of safety concerns which were based on the higher incidence of side effects such as jaundice, urinary side effects and pancreatitis in the DCLHb group.…”

Section: Clinical Studies With Hemoglobin-based Oxygen Carriersmentioning

confidence: 99%

Artificial Oxygen Carriers: Hemoglobin-Based Oxygen Carriers – Current Status 2004

Standl¹

2004

Transfus Med Hemother

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Because of an impending shortfall of allogeneic blood products within the next decades and ongoing problems associated with relevant costs for testing and storage of banked red blood cell (RBC) units, the development of alternatives has been intensified during the last 15 years. Modern chemically modified hemoglobin- based oxygen carriers (HBOC) are free of RBC membrane remnants, renal toxicity, and ABO antigens which allows transfusion without knowledge of the respective blood group of a patient. Bovine polymerized cell-free hemoglobin can be stored at room temperature for 3 years. In contrast to the perfluorocarbon solutions, HBOC can be applied at room air oxygen concentrations. Animal experiments have shown that HBOC can compensate for intravascular volume deficits in hemorrhagic shock, including restoration of colloid osmotic pressure and organ perfusion, and deliver oxygen to organs and tissues during nearly complete blood exchange. Chemical modifications of HBOC are able to reduce the vasoconstrictive side effect of HBOC which is caused by NO scavenging. In spite of vasoconstriction, the increased oxygen extraction in presence of HBOC in combination with the plasmatic oxygen transport provides enhanced tissue oxygenation even in post-stenotic tissues. HBOC seem to improve the diffusive oxygen transport at the microcirculatory site, thus decreasing tissue damage in acute pancreatitis and tissue injury in the heart and brain after ischemia/reperfusion. Clinical studies showed that the perioperative use of different HBOC (Hemopure®, PolyHeme®, Hemolink®, HemAssist®) can reduce the number of allogeneic RBC units and increase the avoidance rate of allogeneic transfusion in emergency bleeding as well as in vascular, cardiac and noncardiac surgery. Polymerized HBOC appear to have a lower potential of side effects in comparison to intramolecularly crosslinked preparations. However, HBOC-201 (Hemopure) is the only substance which has been licensed for the treatment of patients until now.

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Section: Clinical Studies With Hemoglobin-based Oxygen Carriersmentioning

confidence: 99%

Artificial Oxygen Carriers: Hemoglobin-Based Oxygen Carriers – Current Status 2004

Standl¹

2004

Transfus Med Hemother

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“…HBOCs have been tested in several clinical phase III studies, including cardiac and noncardiac (general, vascular, trauma) surgery [28,31,44,51,89,102]. Frequently observed side effects consisted in increased systemic and pulmonary arterial resistances, decrease of cardiac output, jaundice, increased activities of amylase, lipase and hepatic transaminases [44,51,89,102].…”

Section: Hbocmentioning

confidence: 99%

Blood Substitutes

Pape¹,

Häbler²

2010

Tissue Engineering

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“…46,47,48 A Hb-diaspirina foi testada em pacientes em choque hemorrágico e em traumatismo craniano, com resultados surpreendentes. [49][50][51][52] Essa classe de carreadores de oxigênio livre de células é considerada de primeira geração. …”

Section: Carreadores De Oxigênio Baseados Em Hemoglobinaunclassified

Importância dos carreadores de oxigênio livre de células

Novaretti¹

2007

Rev. Bras. Hematol. Hemoter.

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IntroduçãoNo mundo todo, a necessidade de transfusões sangüíneas vem crescendo progressivamente. No Brasil, enquanto a demanda de sangue cresce à taxa de 1% ao ano, as expectativas de crescimento das doações de sangue variam de 0,5 a 0,7%/ano. 1 Conseqüentemente, a estimativa para o ano de 2030 é de um déficit de aproximadamente um milhão de unidades de sangue coletado, levando-se em conta o crescimento populacional projetado e as necessidades crescentes de transfusão, em especial para os que a necessitam cronicamente, para cirurgias de grande complexidade e no atendimento às emergências.2 Deve-se ressaltar que essa projeção não inclui situações de calamidade pública e desastres naturais.Se estimarmos as necessidades internacionais de transfusão de sangue e componentes, tendo por base a estimativa de 0,05 unidades per capita por ano, pode ser projetada uma demanda de assustadoras 300 milhões de unidades de sangue por ano.3 Quando são computados os números disponí-veis de transfusões de sangue em termos mundiais, temos cerca de 90 milhões de unidades transfundidas por ano. Caso esse número seja verdadeiro, há falta de 200 milhões de bolsas de sangue/ano. 4 Obviamente essas estimativas estão sujeitas a críticas, mas é evidente que não há suprimento total de sangue, particularmente de alguns tipos (como os Rhnegativo) em situações emergenciais, e a sazonalidade é importante fator que compromete o fornecimento de sangue. Deve-se ressaltar que, apesar de os progressos para o aumento da segurança transfusional e da diminuição vertigi-

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Diaspirin-Crosslinked Hemoglobin Reduces Blood Transfusion in Noncardiac Surgery: A Multicenter, Randomized, Controlled, Double-Blinded Trial

Cited by 63 publications

References 19 publications

Artificial Oxygen Carriers: Hemoglobin-Based Oxygen Carriers – Current Status 2004

Artificial Oxygen Carriers: Hemoglobin-Based Oxygen Carriers – Current Status 2004

Blood Substitutes

Importância dos carreadores de oxigênio livre de células

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