Critical Care
Volume 8
Suppl 2 |
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ReviewAlternatives to blood in the 21st centuryStephen M Cohn  Professor and Chief, Divisions of Trauma and Surgical Critical Care, Daughtry Family Department of Surgery, University of Miami School of Medicine, Miami, Florida, USA  author email corresponding author email
Critical Care 2004,
8(Suppl 2):S15-S17doi:10.1186/cc2412 Abstract
Persons who suffer traumatic injury are likely to be transfused with considerable amounts of blood during initial resuscitation efforts. Oxygen-carrying solutions are currently in clinical testing as substitutes for red blood cells. Although these agents may eliminate many concerns associated with blood administration (short shelf life, infectious and immunologic risks, the need to type and cross-match), early cell-free hemoglobin solutions demonstrated nephrotoxicity and were associated with pulmonary and systemic hypertension, among other adverse events. Newer polymerized hemoglobin solutions show acceptable safety profiles in the surgical setting and studies are being designed, some with funding from the US Department of Defense, to evaluate their efficacy in hemorrhaging trauma victims. | 
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