Thursday December 22, 2005
Whats new on Horizon - blood substitutes
Being an intensivist it is imperative to keep up with all new "stuff" on horizon. In this regard blood substitutes will soon actually be knocking on the door. Hemopure, a Bovine derived blood substitute, has been approved for use in adult patients in South Africa. Polyheme, a human derived blood substitute is already in Phase III trial in united states for hemorrhagic shock following traumatic injuries. These are solutions of chemically modified human or bovine hemoglobin which restores lost blood volume and can be given as rapid, massive infusion. One unit is equal to one unit of pRBC and can be given wide open.
Advantages: Does not require typing or cross-matching before infusion and so far found not to cause transfusion reactions. Shelf life of over 12 months (ciruclation time is 1-2 days) and does not require refrigeration. Bovine based Hemopure has been said acceptable for use in Jehovah's Witnesses (?).
Disadvantages: No evidence based data available yet. Concerns raised re. Mad cow disease in bovine based Hemopure !.
Read interesting critical commentary on above products here from Randy Dotinga at wired.com
References: Click to get abstract/article
1. Safety and Efficacy of PolyHeme(R) in Hemorrhagic Shock Following Traumatic Injuries Beginning in the Pre-Hospital Setting - clinicaltrials.gov
2. Watchtower Approves HemoPure for Jehovah's Witnesses - ajwrb.org
3. Effect of Hemopure® on Prothrombin Time and Activated Partial Thromboplastin Time on Seven Coagulation Analyzers, - Clinical Chemistry. 1997;43:1792
4. PolyHeme - American College of Surgeons at facs.org