Severe anemia after gastrointestinal hemorrhage in a Jehovah’s Witness: new treatment strategies.

Somewhat similar to the letter published by Cothren et al. in the NEJM, this article reports the case of a Jehovah’s witness who bled to a nadir hemoglobin concentration of 3.5 g/dL and was treated with 7 units of a bovine hemoglobin-based oxygen carrier and high-dose erythropoietin. No data are presented on oxygen transport variables, leaving us to wonder what benefit, if any, accrued to the patient who died on day 37 of sepsis after experiencing multiple organ dysfunction. Of note, the patient’s death is not mentioned in the title of the article or in the abstract… High-dose erythropoietin resulted in a rise of hemoglobin concentration to 7.6 g/dL in 30 days of therapy, a finding commensurate with previous reports.
The article is interesting but does little to support the use of hemoglobin-based oxygen carriers in severely anemic patients.

– J.-F. Hardy