This article is part of the supplement: Anemia in Critical Care: Etiology, Treatment and Prevention .

Review

Hemoglobin-based oxygen carriers

A Gerson Greenburg¹ and Hae Won Kim²

¹Professor of Surgery, Brown University School of Medicine, Providence, Rhode Island, USA

²Director of Surgical Research, The Miriam Hospital, Providence, Rhode Island, and Assistant Professor of Surgery, Brown University School of Medicine, Providence, Rhode Island, USA

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Critical Care 2004, 8(Suppl 2):S61-S64doi:10.1186/cc2455

Published:	14 June 2004

Abstract

Transfusable fluids that may be used as alternatives to red blood cell transfusion offer the promise of preserving tissue perfusion and minimizing hypoxic cellular damage, and this promise may soon be fulfilled. Clinical testing of hemoglobin-based oxygen carriers has faced and met challenges involving molecular design, safety, efficacy, and regulatory requirements. Three leading candidates have emerged: two human (PolyHeme^® and HemoLink™) and one bovine-based hemoglobin solution (Hemopure^®). Because a survival benefit has been difficult to demonstrate, avoidance of allogeneic transfusion has been adopted as the standard efficacy end-point for these agents. An update on clinical trial status is provided, and the potential utility of hemoglobin-based oxygen carriers in surgery combined with intraoperative autologous donation is discussed.