Use of Oxygen Therapeutics in Patients for Whom Blood Is Not an Option

Hemoglobin-based oxygen carriers (HBOCs) are oxygen therapeutics that have been available for critically ill severely anemic patients for whom blood is not an option through the Expanded Access (also known as “Compassionate Use”) pathway. These agents are used as “oxygen bridges” or “bridging treatments” to sustain the oxygen delivery to the tissues above the critical level needed to avoid tissue ischemia and injury and buy some time for other treatments of anemia (such as erythropoiesis stimulating agents) to exert their effects until endogenous hemoglobin concentration is restored. Several reports of using HBOCs under Expanded Access program have been published which are mostly indicative of successful management of patients with exceedingly low hemoglobin concentrations. While limitations inherent to case series might prevent us from determining the net impact of oxygen therapeutics on the outcomes of patients, these reports provide clinicians and patients with a glimpse of hope.