Hemoglobin solutions--not just red blood cell substitutes.

Abstract:

OBJECTIVE:To review current knowledge about cell-free hemoglobin solutions. DATA SOURCES:All studies involving cell-free hemoglobin were retrieved from a computerized MEDLINE search from 1980 to 1998. We also reviewed the reference lists of all available review articles and primary studies to identify references not found in the computerized search. STUDY SELECTION:Clinical and experimental studies in which cell-free hemoglobin solutions were studied. DATA EXTRACTION:From the selected studies, information was obtained regarding the experimental model or the study population in which cell-free hemoglobin solutions were investigated, the type of cell-free hemoglobin solution, their deleterious or beneficial effects, and their possible indications. DATA SYNTHESIS:In many studies, hemoglobin solutions were considered as efficient resuscitative agents and good alternatives to red blood cell transfusion, because of their marked vasopressor effect coupled with their capacity to improve the microcirculation and quickly restore metabolic parameters. Nevertheless, potential problems include an increased susceptibility to infection, immunosuppression, oxidative damage, excessive pulmonary and systemic vasoconstriction, and platelet activation. CONCLUSIONS: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.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Creteur J,Sibbald W,Vincent JL

doi

10.1097/00003246-200008000-00058

subject

Has Abstract

pub_date

2000-08-01 00:00:00

pages

3025-34

issue

8

eissn

0090-3493

issn

1530-0293

journal_volume

28

pub_type

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