Effects of Hemoglobin-Based Oxygen Carriers on  Blood Coagulation

Roghani, Kimia; Holtby, Randall J.; Jahr, Jonathan S.

doi:10.3390/jfb5040288

Cited by 11 publications

(14 citation statements)

References 29 publications

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“…All tests were performed in the hospital laboratory. The viscoelastic tests were performed on a ROTEM delta™ (Werfen, Instrumentation Laboratory, Bedford, MA, USA) according to the manufacturer's recommendations [ 28 ]. The ROTEM™ assays have been presented in detail elsewhere [ 19 , 20 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Pragmatic study of a thromboprophylaxis algorithm in critically ill patients with SARS-COV-2 infection

Fattorutto

Bouckaert

Brauner

et al. 2021

J Thromb Thrombolysis

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The optimal thromboprophylactic strategy for patients affected by Coronavirus disease 2019 (COVID-19) has been debated among experts. This study evaluated the safety and efficacy of a thromboprophylaxis algorithm. This was a retrospective, single-center study in critically ill patients admitted to the intensive care unit (University affiliated Hospital) for acute respiratory failure due to Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). From March 16 to April 9, 2020, thromboprophylaxis was adjusted according to weight (control group, n = 19) and after this date, thromboprophylaxis depended on an algorithm based on thrombotic and hemorrhagic risk factors (protocol group, n = 13). With regard to safety (number of major bleeding events and blood transfusions), the groups were not significantly different. With regard to efficacy, the number of thrombotic events decreased from 37 to 0%, p = 0.025 after implementation of the algorithm. Also, peak fibrinogen dropped from 8.6 (7.2–9.3) to 6.5 (4.6–8.4) g/L, p = 0.041 and D-dimers from 2194 (1464–3763) to 1486 (900–2582) ng/mL, p = 0.0001. In addition, length of stay declined from 19 (10–31) to 5 (3–19) days, p = 0.009. In conclusion, a tailored thromboprophylaxis algorithm (risk stratification based on clinical parameters and biological markers) reduce thrombotic phenomena in critically ill COVID-19 patients without increasing major bleeding. Supplementary Information The online version of this article (10.1007/s11239-021-02514-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Pragmatic study of a thromboprophylaxis algorithm in critically ill patients with SARS-COV-2 infection

Fattorutto

Bouckaert

Brauner

et al. 2021

J Thromb Thrombolysis

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“…These adverse effects are due to tetramers of hemoglobin being cleaved into dimers. Alleviating the adverse effects, specifically decreasing the severity of vasoconstriction, has led to several modifications such as cross-linkage, polymerization and encapsulation with polyethylene glycol (PEGylation), which will all be discussed ( 30 ).…”

Section: Introductionmentioning

confidence: 99%

Blood substitutes: Basic science, translational studies and clinical trials

Jahr

2022

Front. Med. Technol.

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HemorrhageWhen accident victims are bleeding to death, there have been few medical treatment options to save their lives until they can be rescued and transported to a hospital, despite new campaigns, including use of tranexamic acid as an antifbrinolytic (4).Therefore, work that proposes to develop a new type of fluid, with multiple medical effects, that is designed to improve survival from first-aid treatment by a healthcare professional is warranted. It will include fluids, oxygenating capability (like erythrocytes), blood clotting capability and other essential factors to improve survival-a revolutionary concept for the improvement of current hemorrhagic trauma medical care.

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“…In one, HBOC-201 (Hemoglobin glutamer-250 (bovine), Hemopure, HbO2 Therapeutics, Souderton, PA), a polymerized bovine hemoglobin, eliminated allogenic packed erythrocyte transfusion in a substantial proportion of patients undergoing elective orthopedic surgeries (see Appendix A , Supplemental Digital Content 1 , http://links.lww.com/AJT/A106 for review of the HEM-0115 study). 1–3…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Blood Component Requirements and Erythrocyte Transfusion and Mortality Related to Hemoglobin Deficit in Phase III Trial of Hemoglobin-Based Oxygen Carrier: HBOC-201

Jahr

Williams

2022

American Journal of Therapeutics

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Background: Hemoglobin-based oxygen carriers (HBOCs) may cause coagulopathy, changes in total hemoglobin (THb), and affect mortality. Low total hemoglobin concentrations [THb] during hemorrhage may worsen outcomes.Study Question: The database of the Hemopure HEM-0115 phase III trial was queried to determine the use of platelets, plasma, or cryoprecipitate and compare transfusion requirements and coagulation studies between patients randomized to erythrocyte transfusion or HBOC-201 infusion. Modeling of hemoglobin (Hb) changes produced by HBOC-201, erythrocyte, and blood product administration were related to [THb], coagulopathy, and mortality.Data Sources: Hemopure HEM-0115 phase III trial database.Study Design: Retrospective and Novel Hemoglobin Deficit Formulas Tested Against Existing Database. Results:The HBOC-201 database (n 5 688) demonstrated less than 6% of subjects in both groups were administered non-Hb containing blood products (fresh frozen plasma, platelets, or cryoprecipitate) and low rates of coagulopathies in both erythrocyte and HBOC-201 arms. There were no differences in mortality in elective orthopedic patients administered up to 10 bags HBOC-201 (equivalent to 3 units erythrocytes). Low total [Hb] and lack of adequate oxygen carrying capacity was found to be an independent predictor of morbidity/mortality. Conclusions:The elective use of HBOC-201 for orthopedics versus erythrocytes demonstrated low incidence of blood product requirements in both cohorts and no differences in mortality up to the HBOC-201 equivalent of 3 units erythrocytes. High total Hb may be important to maintain in acute hemorrhage and [Hb] deficit, whereas later in recovery might not be as crucial. Future trauma trials may benefit from the use of HBOC-201 containing 13 g/dL in prehospital management, when erythrocytes are commonly not available.

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Effects of Hemoglobin-Based Oxygen Carriers on Blood Coagulation

Cited by 11 publications

References 29 publications

Pragmatic study of a thromboprophylaxis algorithm in critically ill patients with SARS-COV-2 infection

Pragmatic study of a thromboprophylaxis algorithm in critically ill patients with SARS-COV-2 infection

Blood substitutes: Basic science, translational studies and clinical trials

Blood Component Requirements and Erythrocyte Transfusion and Mortality Related to Hemoglobin Deficit in Phase III Trial of Hemoglobin-Based Oxygen Carrier: HBOC-201

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