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Vet Clin Pathol. 2001;30(1):39-45.
Oxygen saturation measurements in canine blood containing hemoglobin glutamer-200 (Bovine): in vitro validation of the NOVA CO-Oximeter.

Jahr JS, Driessen B, Lurie F, Tang Z, Louie RF, Kost G.

University of California-Davis, School of Medicine, Departments of Anesthesiology and Pain Medicine, University of California-Davis Medical Center, Sacramento, CA, USA. driesseet.upenn.edu

This study was designed to validate in vitro oxygen saturation (SO2) measurements with the NOVA CO-Oximeter (Nova Biomedical Corp, Waltham, Mass, USA) in canine blood containing hemoglobin (Hb) glutamer-200 bovine (Hb-200; Oxyglobin, Biopure, Cambridge, Mass, USA) as a Hb-based oxygen carrier recently introduced into clinical practice. In the first set of experiments, stored blood from 6 mixed-breed canine blood donors was used. Target PO2 levels were reached in aliquots of blood samples by tonometry. Oxygen saturation was then measured with the test device and calculated based on known PO2 values. In the second set of experiments, total oxygen content was directly measured by means of an oxygen-specific electrode in aliquots of fresh whole arterial, venous, and mixed (arterial-venous) blood withdrawn from the same canine blood donors. Hb-200 was added to those blood samples to yield plasma Hb concentrations of 1.62, 3.25, 6.50, and 9.75 g/dL. Based on Hb content and SO2 measured by the NOVA CO-Oximeter in these samples, total oxygen content was also calculated for each sample and compared with measured values. A strong correlation was found between SO2 values measured with the co-oximeter in samples after tonometry, and calculated SO2 based on known PO2. Directly measured total blood O2 content varied by </=5% from values computed based on co-oximeter measurements of Hb content and SO2. These results did not change with different levels of oxygenation of the samples or different plasma Hb-200 concentrations. In conclusion, the NOVA CO-Oximeter is an accurate analyzer for measurement of SO2 after Hb-200 administration to canine blood.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12024330&dopt=Abstract [PubMed - as supplied by publisher]

Med Oncol. 2002;19(1):69-72.
Long-standing resolution of anemia in symptomatic low-grade non-Hodgkin's lymphoma patients treated with recombinant human erythropoietin as sole therapy.

Samuelsson J.

Department of Medicine, Stockholm Southern Hospital, Sweden. jan.samuelssoedklin.sos.sll.se

Anemia is a predominant clinical problem in the management of patients with non-Hodgkin's lymphoma and often an indication to initiate chemotherapy. However, many elderly patients, especially those with concomitant disorders, do not tolerate such therapy very well. This report describes three patients with low-grade non-Hodgkin's lymphoma who were treated solely with recombinant human erythropoietin (rhEPO) for lymphoma-associated anemia. The rhEPO was given at an initial dose of 150 U/kg three times weekly, with dose reduction when a response had been achieved. All three patients normalized their hemoglobin level and severe anemia-related symptoms disappeared. Responses are ongoing in two patients after 10 and 12 mo of therapy, respectively. The third patient maintained a response to rhEPO for over 5 yr, without any need for further therapeutic interventions, before dying of an unrelated event. This treatment strategy seems worthy of further investigation in selected lymphoma patients where anemia is the major complication of the disease.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12025893&dopt=Abstract

Pediatr Nurs. 2000 Jul-Aug;26(4):373-9.
Care of the child with sickle cell disease: acute complications.

Jakubik LD, Thompson M.

Department of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Sickle cell disease (SCD) is a term used to describe a group of genetic disorders of hemoglobin production characterized by a predominance of the abnormal hemoglobin known as hemoglobin S. Common acute complications of SCD in children requiring hospitalization include painful episodes, febrile illness, and splenic sequestration. The staff nurse has an important role in providing prompt treatment and instituting preventative measures to avoid the adverse clinical outcomes of SCD such as acute chest syndrome, severe anemia, cardiovascular instability, and bacterial sepsis. A basic understanding of the pathophysiology of vaso-occlusion, the immune system, hemolysis, and the spleen is essential in the care of a child during an acute complication of SCD. Additionally important are a knowledge of the genetics, pathophysiology, medical and nursing management, and a familiarity with patient and family education material relating to sickle cell disease.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12026471&dopt=Abstract

Artif Cells Blood Substit Immobil Biotechnol. 2002 Mar;30(2):83-98.
The hemodynamic effects of diaspirin cross-linked hemoglobin in dopamine-resistant endotoxic shock in swine.

Freilich E, Freilich D, Hacker M, Leach L, Patel S, Hebert J.

Department of Anesthesiology, University of Vermont, Burlington, USA. freilichmrc.navy.mil

As the blood substitute Diaspirin Cross-linked Hemoglobin (DCLHb) has potent vasopressor activity, we assessed its hemodynamic effects in a clinically relevant dopamine-resistant endotoxic shock model in swine. In a randomized and controlled study, E. coli LPS was administered to anesthetized and invasively monitored swine. Group I (n = 3) control pigs were not resuscitated. Groups II (n = 5) and III (n = 6) pigs received dopamine (DA) after MAP decreased 30%, and hetastarch and DCLHb, respectively, after dopamine-resistance occurred. Progressive hemodynamic decline occurred in Group I pigs. DA failed to restore MAP to baseline. However, 0% and 67% of pigs also treated with heta-starch and DCLHb, respectively, achieved temporary restoration of baseline MAP (p = 0.03), prompting a reduction in the dose of DA in 0% of hetastarch vs. 50% of DCLHb treated pigs. Except for increased MPAP and decreased heart in DCLHb treated pigs (p<0.001), hemodynamics and survival were not different (p>0.05). In conclusion, although DCLHb exacerbated pulmonary hypertension and did not improve O2 utilization or survival, because DCLHb restored MAP to baseline and had a dopamine sparing effect, further investigation of DCLHb's hemodynamic effects in adrenergic agent-resistant endotoxemia is warranted.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12027230&dopt=Abstract

J Am Soc Nephrol. 2003 Jan;14(1):180-6.
Survival advantage for adult Hispanic hemodialysis patients? Findings from the end-stage renal disease clinical performance measures project.

Frankenfield DL, Rocco MV, Roman SH, McClellan WM.

Centers for Medicare & Medicaid Services, Center for Beneficiary Choices, Baltimore, Maryland 21244, USA. dfrankenfielms.hhs.gov

One-year follow-up mortality in Hispanic and non-Hispanic patients and its association with intermediate outcomes of dialytic care were examined utilizing the Center for Medicare & Medicaid Services' (CMS) ESRD Clinical Performance Measures (CPM) Project and administrative data. Demographic and clinical information was collected on a national random sample of adult in-center hemodialysis (HD) patients for the period of October through December, 1998. Patients were categorized as Hispanic, non-Hispanic White, or non-Hispanic Black. Of 8336 patients 994 (12%) were identified as Hispanic, 3618 (43%) as non-Hispanic White, and 3111 (37%) as non-Hispanic Black. The adjusted 12-mo mortality risk (99% CI) for Hispanics was 0.76 (0.60 to 0.96; P < 0.01) and for non-Hispanic Blacks 0.66 (0.56 to 0.78, P < 0.001) compared with non-Hispanic Whites (referent). Similar 12-mo mortality risks were noted in the groups with diabetes mellitus or hypertension as the causes of ESRD and among patients > or = 65 yr. After controlling for demographic and geographic variables, Hispanics compared with the referent group, non-Hispanic Whites, were more likely to have a mean serum albumin > or = 4.0/3.7 g/dL (BCG/BCP) (1.5 [1.2 to 1.7]; P < 0.001) and as likely to have a mean Kt/V > or = 1.2, mean hemoglobin > or = 11 g/dL, and an arteriovenous fistula as their vascular access. These data suggest that adult Hispanic HD patients have a 12-mo survival intermediate to non-Hispanic Blacks and non-Hispanic Whites and experience equivalent or better intermediate outcomes of dialytic care compared with non-Hispanic Whites.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12506150&dopt=Abstract

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