You are caring for a critically ill patient of the Jehovah's Witness faith who has a hemoglobin (Hb) of 5 g/dL and apply to the U.S. Food and Drug Administration (FDA) expanded access program to obtain a blood substitute. According to a recent review article, which of the following blood substitutes or artificial oxygen-carrying products is currently available for use in the U.S.?
Allogeneic blood product transfusion remains the primary treatment modality for significant blood loss and acute perioperative anemia. In situations where blood products are unavailable or religious beliefs prohibit transfusion, an acceptable alternative comparable to erythrocyte transfusion is lacking. The authors of a recent review article described the development, clinical trials, and current clinical availability of artificial oxygen-carrying products.
In the 1930s, purified human Hb was infused into patients, resulting in death due to the dissociation of the Hb tetramer into dimers causing renal toxicity, nitric oxide scavenging...