Using a well recognized experimental model, the authors demonstrated that polymerized bovine-based hemoglobin solution markedly reduced arterial thrombosis rate and increased bleeding time in rabbits. These results are in contrast with those reported with other hemoglobin-based oxygen carriers. There is increasing evidence that the effects of hemoglobin solutions on hemostasis can be influenced by their physico-chemical properties (size of the hemoglobin molecules, cross-linking methodology, etc.).

– Philippe Van der Linden

Marret et al. describe the effects of a bovine derived hemoglobin solution (HBOC-201; Hemopure – Biopure) and of a gelatin solution (Plasmion – Fresenius) in a rabbit model of arterial thrombosis and bleeding. While the use of hemoglobin solutions remains restricted to research and/or to a few specific countries, the results are important to clinicians: neither HBOC-201 nor gelatin solutions increased platelet aggregation or increased thrombus formation. Conversely, both solutions decreased arterial thrombosis and prolonged bleeding time in the rabbit. Total bleeding was slightly increased in rabbits receiving HBOC-201 (yet the difference was not statistically significant) and this may have resulted from the increase in blood pressure seen in these animals. In summary, in this rabbit model of arterial thrombosis and bleeding, the use of HBOC-201 and of a gelatin solution is not associated with hypercoagulability, an undesirable side effect in the perioperative context.

– Jean-Franois Hardy