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Bernd Driessen - One of the best experts on this subject based on the ideXlab platform.
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Lactate measurement interference by Hemoglobin-based oxygen carriers (Oxyglobin, Hemopure, and Hemolink).
Anesthesia & Analgesia, 2005Co-Authors: Jonathan S Jahr, Robert A. Gunther, Stephen L. Osgood, Stephen J. Rothenberg, Qiao-ling Li, Anthony W. Butch, Anthony T.w. Cheung, Bernd DriessenAbstract:We sought to determine whether Hemoglobin-based oxygen carriers (HBOCs), Hemoglobin glutamer-200 [bovine] (HBOC-200, Oxyglobin®), Hemoglobin glutamer-250 [bovine] (HBOC-201, Hemopure®), and Hemoglobin Raffimer (Hemolink) interfere with the accuracy of lactate measurements. Combinations of concentrated L-lactate solution, HBOC, and blood or plasma with added PlasmaLyte-A were added to sample tubes to make a linear and constant increase in lactate concentration in consecutive samples. Sample lactate concentrations ranged from 5-110 mg/dL (0.6-12 mM) (physiological reference range: 5-20 mg/dL [0.56-2.2 mM]). Comparisons were made between machine measured lactate concentrations and calculated lactate concentrations. For Hb glutamer-250, the average difference between measured and calculated lactate concentrations was -5.1 mg/dL (-0.57 mM) (LX-20®), with greater underestimation at larger lactate concentrations. For Hb Raffimer, the average difference was -2.2 mg/dL (-0.24 mM) (LX-20®). The veterinary product, Hb glutamer-200, was tested on 3 analyzers (LX-20®, YSI 1500, and YSI 2300). The YSI 1500 was the most accurate instrument with the mean difference between measured minus calculated lactate being +1.3 mg/dL versus -2.6 mg/dL (YSI 2300) and -8.4 mg/dL (LX-20®). The clinical implications of this study are that with increasing levels of an HBOC in plasma, lactate interpretation may become inaccurate, especially at larger lactate concentrations, causing underestimation of measured lactate values and possible under-treatment of the patient. Therefore, caution must be exercised when interpreting lactate results when a HBOC is present in plasma.
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the novel hemocue plasma low Hemoglobin system accurately measures small concentrations of three different Hemoglobin based oxygen carriers in plasma Hemoglobin glutamer 200 bovine oxyglobin Hemoglobin glutamer 250 bovine hemopure and Hemoglobin raff
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of Hemoglobin concentrations determined with the bedside photometer were not significantly different from known values of Hemoglobin concentration in the samples. There was no significant difference between values obtained by two independent observers for the same samples. This was true for all three tested HBOCs and for all tested concentrations. The mean bias of the measurement expressed as a percentage of sample concentration was 0.1% for Hemoglobin glutamer-200 (bovine), 0.58% for Hemoglobin glutamer-250 (bovine), and 0.19% for Hemoglobin-Raffimer. The mean error was <8% for all three HBOCs. Both intraobserver and interobserver reliabilities were high and statistically significant. The HemoCue Plasma/Low Hemoglobin System is a reliable instrument for detecting and measuring small concentrations of three different HBOCs in plasma. IMPLICATIONS: This study evaluated a new bedside blood-measuring device for low levels and found that it rapidly measured low levels accurately for three blood substitutes.
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The novel HemoCue® plasma/low Hemoglobin system accurately measures small concentrations of three different Hemoglobin-based oxygen carriers in plasma: Hemoglobin glutamer-200 (bovine) (Oxyglobin®), Hemoglobin glutamer-250 (bovine) (Hemopure®), and h
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of
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The HemoCue, a point of care B-Hemoglobin photometer, measures Hemoglobin concentrations accurately when mixed in vitro with canine plasma and three Hemoglobin-based oxygen carriers (HBOC).
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Jonathan S Jahr, Fedor Lurie, Bernd Driessen, J. Davis, Robert C. Gosselin, Robert A. GuntherAbstract:g·L –1 for Hemoglobin glutamer-250 and 1.07 g·L –1 and 0.85 g·L –1 for Hemoglobin-Raffimer. An acceptable agreement was found between the B-Hemoglobin photometer and the laboratory analyzer for all three HBOCs tested. Conclusion: The B-Hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma.
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The HemoCue®, a point of care B-Hemoglobin photometer, measures Hemoglobin concentrations accurately when mixedin vitro with canine plasma and three Hemoglobin-based oxygen carriers (HBOC)
Canadian Journal of Anesthesia, 2002Co-Authors: Jonathan S Jahr, Fedor Lurie, Bernd Driessen, Jessica A. Davis, Robert Gosselin, Robert A. GuntherAbstract:Purpose Accuracy of measurement of low Hemoglobin concentrations using the HemoCue®, a B-Hemoglobin photometer (HemoCue AB, Angelholm, Sweden) may exhibit significant variability. Infusion of Hemoglobin-based oxygen carriers (HBOC) results in low concentrations of plasma Hemoglobin. Our study assessed B-Hemoglobin photometer measurement accuracy of three HBOC: (Hemoglobin glutamer-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA); Hemoglobin glutamer-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA), and Hemoglobin-Raffimer, (human; Hemolink™, Hemosol, Inc., Toronto, Ontario, Canada). Methods In the laboratory, 45 split canine plasma samples were mixed with Hemoglobin glutamer-200 (8.13, 16.25, 32.5 g·L^−1 concentrations), 45 samples were mixed with Hemoglobin glutamer-250 (8.13, 16.25, 32.5 g·L^−1 concentrations), 45 with Hemoglobin-Raffimer (12.5, 25.0, 50.0 g·L^−1 concentrations), and measured. Plasma samples without HBOC served as control. Hemoglobin concentration was determined by a laboratory analyzer (Coulter Corporation, Hiafeah, FL, USA) and B-Hemoglobin photometer (HemoCue®, Ångelholm, Sweden). Two independent technicians performed blinded sample measurements and randomly tested each sample five times. Results were analyzed according to Bland and Altman analysis. Results B-Hemoglobin photometer demonstrated high repeatability for all three HBOCs. Repeatability coefficients were 0.37 g·L^−1 and 0.48 g·L^−1 for Hemoglobin glutamer-200, 0.39 g·L^−1 and 0.4 g·L^−1 for Hemoglobin glutamer-250 and 1.07 g·L^−1 and 0.85 g·L^−1 for Hemoglobin-Raffimer. An acceptable agreement was found between the B-Hemoglobin photometer and the laboratory analyzer for all three HBOCs tested. Conclusion The B-Hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma. Objectif La précision des mesures de faibles concentrations d’hémoglobine réalisées avec le HemoCue®, photomètre pour B-hémoglobine (HemoCue AB, Angelholm, Suède), peut afficher une variabilité significative. Une perfusion de transporteurs d’oxygène à base d’hémoglobine (TOBH) entraîne de faibles concentrations d’hémoglobine plasmatique. Notre étude a évalué la précision du photomètre pour B-hémoglobine de trois TOBH : (l’hémoglobine glutamère-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA) ; l’hémoglobine glutamère-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA) et l’hémoglobine-raffimère (humaine; HemolinkTM, Hemosol, Inc., Toronto, Ontario, Canada). Méthode Au laboratoire, 45 échantillons divisés de plasma canin ont été combinés à de l’hémoglobine glutamère-200 (des concentrations de 8,13 - 16,25 - 32,5 g·L^−1), 45 avec de l’hémoglobine glutamère-250 (8,13 - 16,25 - 32,5 g·L^−1) et 45 avec de l’hémoglobine-raffimère (12,5 - 25,0 - 50,0 g·L^−1), puis mesurés. Les échantillons plasmatiques sans TOBH constituaient les témoins. La concentration d’hémoglobine a été déterminée à l’aide d’un analyseur de laboratoire (Coulter Corporation, Hiafeah, FL, USA) et du photomètre pour B-hémoglobine (HemoCue®, Ångelholm, Sweden). Deux techniciens objectifs ont mesuré les échantillons sansen connaître la nature et ont testé chacun cinq fois de façon aléatoire. Les résultats ont été analysés à partir des méthodes de Bland et Altman. Résultats Le photomètre pour B-hémoglobine a démontré une grande fidélité pour les trois TOBH. Les coefficients de répétabilité ont été de 0,37 g·L^−1 et de 0,48 g·L^−1 pour l’hémoglobine glutamère-200 ; 0,39 g·L^−1 et 0,4 g·L^−1 pour l’hémoglobine glutamère-250 et 1,07 g·L^−1 et 0,85 g·L^−1 pour l’hémoglobine-raffimère. Il y avait une concordance acceptable entre le photomètre pour B-hémoglobine et l’analyseur de laboratoire en regard des trois TOBH testés. Conclusion Le photomètre pour B-hémoglobine a permis de déterminer avec exactitude la concentration de trois solutions de TOBH dissoutes dans du plasma canin.
Steven E Hill - One of the best experts on this subject based on the ideXlab platform.
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use of Hemoglobin Raffimer for postoperative life threatening anemia in a jehovah s witness
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2005Co-Authors: Marcella J. Lanzinger, Laura E. Niklason, Michael Shannon, Steven E HillAbstract:Purpose To describe the successful treatment of acute, life-threatening anemia with the oxygen therapeutic agent, Hemoglobin (Hb) Raffimer.
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Use of Hemoglobin Raffimer for postoperative life-threatening anemia in a Jehovah’s Witness
Canadian Journal of Anesthesia, 2005Co-Authors: Marcella J. Lanzinger, Steven E Hill, Laura E. Niklason, Michael ShannonAbstract:Purpose To describe the successful treatment of acute, life-threatening anemia with the oxygen therapeutic agent, Hemoglobin (Hb) Raffimer. Clinical features A 53-yr-old female Jehovah’s Witness developed severe anemia following total hip replacement. Due to prior patient directive, red blood cells were not transfused. Tachycardia, hypotension, electrocardiographic abnormalities and mental status changes developed with a nadir Hb concentration of 3.2 g.dL_-1. Hb Raffimer is a purified, cross-linked, human Hb solution developed as a substitute for red blood cell Hb. After obtaining informed consent as well as Food and Drug Administration and Institutional Review Board approval for compassionate use, 2 L of Hb Raffimer (Hemolink, Hemosol, Inc., Toronto, ON, Canada) were administered along with ferrous sulfate and epoetin alfa therapy. The patient’s Hb level rose to 5.5 g.dL_-1 with resolution of symptoms. To allow recovery of red blood cell mass while maintaining Hb level > 4.5 g.dL_-1, additional 1000 mL doses of Hb Raffimer were administered on postoperative days three, five and seven (total dose = 500 g Hb). The patient developed no serious adverse events related to treatment with Hb Raffimer. By postoperative day 14, the patient’s Hb level increased to 6.5 g.dL_-1 with a hematocrit of 23%. The patient was discharged. Conclusions Use of Hb Raffimer as a bridge to recovery of this patient’s red blood cell mass may have prevented adverse clinical outcome. Because this product is a purified Hb solution devoid of other cellular components, it may be accepted as therapy by patients who, due to religious conviction, refuse allogeneic red blood cell transfusion. Objectif Décrire le traitement réussi d’une grave anémie aiguë avec un agent d’oxygénothérapie, un raffimère d’hémoglobine (Hb). éléments cliniques Une femme de 53 ans, témoin de Jéhovah, souffrait d’anémie sévère post-arthroplastie totale de la hanche. Elle refusait toute transfusion sanguine. De la tachycardie, de l’hypotension, des anomalies électrocardiographiques et des changements de l’état mental sont apparus avec une concentration d’Hb minimale de 3,2 g.dL_-1. Le raffimère d’Hb est une solution d’Hb humaine purifiée, polymérisée, développée comme substitut de l’Hb des globules rouges. Avec l’approbation, pour usage humanitaire, de la patiente, de la Food and Drug Administration et du Comité d’examen de l’institution, 2 L de raffimère d’Hb (Hemolink, Hemosol, Inc., Toronto, ON, Canada) ont été administrés avec du sulfate ferreux et de l’érythropoïétine humaine. L’Hb s’est élevée à 5,5 g.dL_-1 avec la résolution des symptômes. Pour assurer la récupération de la masse sanguine tout en maintenant le niveau d’Hb > 4,5 g.dL_-1, des doses additionnelles de 1000 mL de raffimère d’Hb ont été donnés aux jours trois, cinq et sept postopératoires (dose totale = 500 g d’Hb). Aucune complication sérieuse liée au raffimère d’Hb ne s’est développée. Au jour postopératoire 14, le niveau d’Hb est monté à 6,5 g.dL_-1 avec un hématocrite de 23 %. La patiente a reçu son congé. Conclusion Le raffimère d’Hb, utilisé pour favoriser la récupération de la masse sanguine peut avoir évité des complications cliniques. Cette solution d’Hb purifiée dépourvue d’autres composantes cellulaires peut constituer un traitement acceptable aux patients qui, par conviction religieuse, refusent une transfusion allogénique.
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safety and preliminary efficacy of Hemoglobin Raffimer for patients undergoing coronary artery bypass surgery
Journal of Cardiothoracic and Vascular Anesthesia, 2002Co-Authors: Steven E Hill, Lewis I Gottschalk, Katherine P GrichnikAbstract:Abstract Objective: To evaluate the safety and preliminary efficacy of escalating doses of Hemoglobin Raffimer (Hemolink) with intraoperative autologous blood donation for coronary artery bypass graft (CABG) surgery. Design: Randomized, controlled, single-blind phase II dose escalation trial. Setting: Multi-institutional university setting. Participants: Adult patients (n = 60) undergoing elective CABG surgery. Interventions: After induction of anesthesia, autologous whole blood was collected to achieve a Hemoglobin of 7 g/dL on cardiopulmonary bypass. Patients were randomized to receive either Hemoglobin Raffimer (treatment) or 6% hetastarch (control) in sequential escalating dose blocks of 250 mL, 500 mL, or 750 mL. After return of autologous blood, allogeneic red blood cells were transfused according to predetermined Hemoglobin triggers. Measurements and Main Results: Safety parameters (vital signs, hematology, blood chemistry, coagulation, and adverse events) were monitored from randomization through week 4 postdischarge. Serious adverse events were distributed evenly between the 2 groups of patients. Elevated blood pressure was more frequent in the treatment group (16/28 mmHg v 9/32 mmHg, p = 0.036). In the group of 40 patients in the 750-mL dose block, 8 of the 18 treatment patients and 4 of the 22 control patients avoided allogeneic red blood cell transfusion (p = 0.093). Median volume of allogeneic red blood cells transfused was lower in treated subjects compared with controls (p = 0.042). Conclusion: Hemoglobin Raffimer is well tolerated and may be effective in reducing transfusion for patients undergoing CABG surgery. Although perioperative hypertension was more frequent in the treated patients, blood pressure management prevented serious adverse sequelae. Definitive evaluation of efficacy in a larger phase III trial is warranted. Copyright 2002, Elsevier Science (USA). All rights reserved.
Fedor Lurie - One of the best experts on this subject based on the ideXlab platform.
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the novel hemocue plasma low Hemoglobin system accurately measures small concentrations of three different Hemoglobin based oxygen carriers in plasma Hemoglobin glutamer 200 bovine oxyglobin Hemoglobin glutamer 250 bovine hemopure and Hemoglobin raff
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of Hemoglobin concentrations determined with the bedside photometer were not significantly different from known values of Hemoglobin concentration in the samples. There was no significant difference between values obtained by two independent observers for the same samples. This was true for all three tested HBOCs and for all tested concentrations. The mean bias of the measurement expressed as a percentage of sample concentration was 0.1% for Hemoglobin glutamer-200 (bovine), 0.58% for Hemoglobin glutamer-250 (bovine), and 0.19% for Hemoglobin-Raffimer. The mean error was <8% for all three HBOCs. Both intraobserver and interobserver reliabilities were high and statistically significant. The HemoCue Plasma/Low Hemoglobin System is a reliable instrument for detecting and measuring small concentrations of three different HBOCs in plasma. IMPLICATIONS: This study evaluated a new bedside blood-measuring device for low levels and found that it rapidly measured low levels accurately for three blood substitutes.
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The novel HemoCue® plasma/low Hemoglobin system accurately measures small concentrations of three different Hemoglobin-based oxygen carriers in plasma: Hemoglobin glutamer-200 (bovine) (Oxyglobin®), Hemoglobin glutamer-250 (bovine) (Hemopure®), and h
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of
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The HemoCue, a point of care B-Hemoglobin photometer, measures Hemoglobin concentrations accurately when mixed in vitro with canine plasma and three Hemoglobin-based oxygen carriers (HBOC).
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Jonathan S Jahr, Fedor Lurie, Bernd Driessen, J. Davis, Robert C. Gosselin, Robert A. GuntherAbstract:g·L –1 for Hemoglobin glutamer-250 and 1.07 g·L –1 and 0.85 g·L –1 for Hemoglobin-Raffimer. An acceptable agreement was found between the B-Hemoglobin photometer and the laboratory analyzer for all three HBOCs tested. Conclusion: The B-Hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma.
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The HemoCue®, a point of care B-Hemoglobin photometer, measures Hemoglobin concentrations accurately when mixedin vitro with canine plasma and three Hemoglobin-based oxygen carriers (HBOC)
Canadian Journal of Anesthesia, 2002Co-Authors: Jonathan S Jahr, Fedor Lurie, Bernd Driessen, Jessica A. Davis, Robert Gosselin, Robert A. GuntherAbstract:Purpose Accuracy of measurement of low Hemoglobin concentrations using the HemoCue®, a B-Hemoglobin photometer (HemoCue AB, Angelholm, Sweden) may exhibit significant variability. Infusion of Hemoglobin-based oxygen carriers (HBOC) results in low concentrations of plasma Hemoglobin. Our study assessed B-Hemoglobin photometer measurement accuracy of three HBOC: (Hemoglobin glutamer-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA); Hemoglobin glutamer-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA), and Hemoglobin-Raffimer, (human; Hemolink™, Hemosol, Inc., Toronto, Ontario, Canada). Methods In the laboratory, 45 split canine plasma samples were mixed with Hemoglobin glutamer-200 (8.13, 16.25, 32.5 g·L^−1 concentrations), 45 samples were mixed with Hemoglobin glutamer-250 (8.13, 16.25, 32.5 g·L^−1 concentrations), 45 with Hemoglobin-Raffimer (12.5, 25.0, 50.0 g·L^−1 concentrations), and measured. Plasma samples without HBOC served as control. Hemoglobin concentration was determined by a laboratory analyzer (Coulter Corporation, Hiafeah, FL, USA) and B-Hemoglobin photometer (HemoCue®, Ångelholm, Sweden). Two independent technicians performed blinded sample measurements and randomly tested each sample five times. Results were analyzed according to Bland and Altman analysis. Results B-Hemoglobin photometer demonstrated high repeatability for all three HBOCs. Repeatability coefficients were 0.37 g·L^−1 and 0.48 g·L^−1 for Hemoglobin glutamer-200, 0.39 g·L^−1 and 0.4 g·L^−1 for Hemoglobin glutamer-250 and 1.07 g·L^−1 and 0.85 g·L^−1 for Hemoglobin-Raffimer. An acceptable agreement was found between the B-Hemoglobin photometer and the laboratory analyzer for all three HBOCs tested. Conclusion The B-Hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma. Objectif La précision des mesures de faibles concentrations d’hémoglobine réalisées avec le HemoCue®, photomètre pour B-hémoglobine (HemoCue AB, Angelholm, Suède), peut afficher une variabilité significative. Une perfusion de transporteurs d’oxygène à base d’hémoglobine (TOBH) entraîne de faibles concentrations d’hémoglobine plasmatique. Notre étude a évalué la précision du photomètre pour B-hémoglobine de trois TOBH : (l’hémoglobine glutamère-200 (bovine; Oxyglobin®, Biopure Corp., Cambridge, MA, USA) ; l’hémoglobine glutamère-250 (bovine; Hemopure®, Biopure Corp, Cambridge, MA, USA) et l’hémoglobine-raffimère (humaine; HemolinkTM, Hemosol, Inc., Toronto, Ontario, Canada). Méthode Au laboratoire, 45 échantillons divisés de plasma canin ont été combinés à de l’hémoglobine glutamère-200 (des concentrations de 8,13 - 16,25 - 32,5 g·L^−1), 45 avec de l’hémoglobine glutamère-250 (8,13 - 16,25 - 32,5 g·L^−1) et 45 avec de l’hémoglobine-raffimère (12,5 - 25,0 - 50,0 g·L^−1), puis mesurés. Les échantillons plasmatiques sans TOBH constituaient les témoins. La concentration d’hémoglobine a été déterminée à l’aide d’un analyseur de laboratoire (Coulter Corporation, Hiafeah, FL, USA) et du photomètre pour B-hémoglobine (HemoCue®, Ångelholm, Sweden). Deux techniciens objectifs ont mesuré les échantillons sansen connaître la nature et ont testé chacun cinq fois de façon aléatoire. Les résultats ont été analysés à partir des méthodes de Bland et Altman. Résultats Le photomètre pour B-hémoglobine a démontré une grande fidélité pour les trois TOBH. Les coefficients de répétabilité ont été de 0,37 g·L^−1 et de 0,48 g·L^−1 pour l’hémoglobine glutamère-200 ; 0,39 g·L^−1 et 0,4 g·L^−1 pour l’hémoglobine glutamère-250 et 1,07 g·L^−1 et 0,85 g·L^−1 pour l’hémoglobine-raffimère. Il y avait une concordance acceptable entre le photomètre pour B-hémoglobine et l’analyseur de laboratoire en regard des trois TOBH testés. Conclusion Le photomètre pour B-hémoglobine a permis de déterminer avec exactitude la concentration de trois solutions de TOBH dissoutes dans du plasma canin.
Jonathan S Jahr - One of the best experts on this subject based on the ideXlab platform.
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Crosslinked, Polymerized, and PEG-Conjugated Hemoglobin-Based Oxygen Carriers: Clinical Safety and Efficacy of Recent and Current Products
Current Drug Discovery Technologies, 2012Co-Authors: Jonathan S Jahr, Arezou Sadighi Akha, Randall J. HoltbyAbstract:Blood substitutes, especially Hemoglobin based oxygen carriers (HBOC) have been widely studied and reviewed over the past 30 years. The development of HBOCs was highlighted by crosslinking to minimize adverse effects. However, even early attempts at single crosslinking using alpha-alpha crosslinks or diaspirin crosslinking failed clinical trials due to renal morbidity and increased mortality. In fact, preclinical trials may have predicted failure of this first generation product, DCLHb (diaspirin-crosslinked Hb) (HemAssist ®, Baxter). In the 1980's, three small biopharmaceutical companies developed "second generation" HBOCs, the first being Hemosol with their raffinose crosslinked HBOC, Hemoglobin- Raffimer. The other two development programs modified the HBOC using glutaraldehyde polymerization, in an attempt to further alleviate the toxicities of the "first" generation HBOCs. This paper will review the definitive clinical trials of the two polymerized HBOCs, Biopure's Hemoglobin glutamer-250 (bovine) and Northfield's polymerized human Hb, pegylated HBOC and Sangart's peg-conjugated HBOC, with an introductory brief review of Hemosol's HemoglobinRaffimer. The paper will then introduce the newest polymerized Hemoglobin, zero-linked Hemoglobin polymer, which has not yet undergone clinical trials but has undergone some preclinical work that will be discussed in a section on this product. As a new generation HBOC, zero-linked Hemoglobin polymer may begin to address the issues presented by the first two generations of HBOCs, and may hold promise as a universally applicable HBOC.
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Lactate measurement interference by Hemoglobin-based oxygen carriers (Oxyglobin, Hemopure, and Hemolink).
Anesthesia & Analgesia, 2005Co-Authors: Jonathan S Jahr, Robert A. Gunther, Stephen L. Osgood, Stephen J. Rothenberg, Qiao-ling Li, Anthony W. Butch, Anthony T.w. Cheung, Bernd DriessenAbstract:We sought to determine whether Hemoglobin-based oxygen carriers (HBOCs), Hemoglobin glutamer-200 [bovine] (HBOC-200, Oxyglobin®), Hemoglobin glutamer-250 [bovine] (HBOC-201, Hemopure®), and Hemoglobin Raffimer (Hemolink) interfere with the accuracy of lactate measurements. Combinations of concentrated L-lactate solution, HBOC, and blood or plasma with added PlasmaLyte-A were added to sample tubes to make a linear and constant increase in lactate concentration in consecutive samples. Sample lactate concentrations ranged from 5-110 mg/dL (0.6-12 mM) (physiological reference range: 5-20 mg/dL [0.56-2.2 mM]). Comparisons were made between machine measured lactate concentrations and calculated lactate concentrations. For Hb glutamer-250, the average difference between measured and calculated lactate concentrations was -5.1 mg/dL (-0.57 mM) (LX-20®), with greater underestimation at larger lactate concentrations. For Hb Raffimer, the average difference was -2.2 mg/dL (-0.24 mM) (LX-20®). The veterinary product, Hb glutamer-200, was tested on 3 analyzers (LX-20®, YSI 1500, and YSI 2300). The YSI 1500 was the most accurate instrument with the mean difference between measured minus calculated lactate being +1.3 mg/dL versus -2.6 mg/dL (YSI 2300) and -8.4 mg/dL (LX-20®). The clinical implications of this study are that with increasing levels of an HBOC in plasma, lactate interpretation may become inaccurate, especially at larger lactate concentrations, causing underestimation of measured lactate values and possible under-treatment of the patient. Therefore, caution must be exercised when interpreting lactate results when a HBOC is present in plasma.
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the novel hemocue plasma low Hemoglobin system accurately measures small concentrations of three different Hemoglobin based oxygen carriers in plasma Hemoglobin glutamer 200 bovine oxyglobin Hemoglobin glutamer 250 bovine hemopure and Hemoglobin raff
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of Hemoglobin concentrations determined with the bedside photometer were not significantly different from known values of Hemoglobin concentration in the samples. There was no significant difference between values obtained by two independent observers for the same samples. This was true for all three tested HBOCs and for all tested concentrations. The mean bias of the measurement expressed as a percentage of sample concentration was 0.1% for Hemoglobin glutamer-200 (bovine), 0.58% for Hemoglobin glutamer-250 (bovine), and 0.19% for Hemoglobin-Raffimer. The mean error was <8% for all three HBOCs. Both intraobserver and interobserver reliabilities were high and statistically significant. The HemoCue Plasma/Low Hemoglobin System is a reliable instrument for detecting and measuring small concentrations of three different HBOCs in plasma. IMPLICATIONS: This study evaluated a new bedside blood-measuring device for low levels and found that it rapidly measured low levels accurately for three blood substitutes.
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The novel HemoCue® plasma/low Hemoglobin system accurately measures small concentrations of three different Hemoglobin-based oxygen carriers in plasma: Hemoglobin glutamer-200 (bovine) (Oxyglobin®), Hemoglobin glutamer-250 (bovine) (Hemopure®), and h
Anesthesia & Analgesia, 2002Co-Authors: Fedor Lurie, Jonathan S Jahr, Bernd DriessenAbstract:UNLABELLED: The accuracy of the HemoCue Plasma/Low Hemoglobin System was validated in vitr. with low levels of Hemoglobin-based oxygen carriers (HBOCs). Repeated measurements were performed on 50 samples of canine plasma, each mixed with three different HBOCs at varying small concentrations (a total of 150 samples), by using plasma samples without HBOCs as controls. Two technicians performed the measurements and randomly tested each sample 10 times. The results were analyzed for correlation, and analysis of variance was used to evaluate statistical significance, with a P value of
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The HemoCue, a point of care B-Hemoglobin photometer, measures Hemoglobin concentrations accurately when mixed in vitro with canine plasma and three Hemoglobin-based oxygen carriers (HBOC).
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Jonathan S Jahr, Fedor Lurie, Bernd Driessen, J. Davis, Robert C. Gosselin, Robert A. GuntherAbstract:g·L –1 for Hemoglobin glutamer-250 and 1.07 g·L –1 and 0.85 g·L –1 for Hemoglobin-Raffimer. An acceptable agreement was found between the B-Hemoglobin photometer and the laboratory analyzer for all three HBOCs tested. Conclusion: The B-Hemoglobin photometer accurately determined the concentration of three HBOC solutions dissolved in canine plasma.
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Use of Hemoglobin Raffimer for postoperative life-threatening anemia in a Jehovah’s Witness
Canadian Journal of Anesthesia, 2005Co-Authors: Marcella J. Lanzinger, Steven E Hill, Laura E. Niklason, Michael ShannonAbstract:Purpose To describe the successful treatment of acute, life-threatening anemia with the oxygen therapeutic agent, Hemoglobin (Hb) Raffimer. Clinical features A 53-yr-old female Jehovah’s Witness developed severe anemia following total hip replacement. Due to prior patient directive, red blood cells were not transfused. Tachycardia, hypotension, electrocardiographic abnormalities and mental status changes developed with a nadir Hb concentration of 3.2 g.dL_-1. Hb Raffimer is a purified, cross-linked, human Hb solution developed as a substitute for red blood cell Hb. After obtaining informed consent as well as Food and Drug Administration and Institutional Review Board approval for compassionate use, 2 L of Hb Raffimer (Hemolink, Hemosol, Inc., Toronto, ON, Canada) were administered along with ferrous sulfate and epoetin alfa therapy. The patient’s Hb level rose to 5.5 g.dL_-1 with resolution of symptoms. To allow recovery of red blood cell mass while maintaining Hb level > 4.5 g.dL_-1, additional 1000 mL doses of Hb Raffimer were administered on postoperative days three, five and seven (total dose = 500 g Hb). The patient developed no serious adverse events related to treatment with Hb Raffimer. By postoperative day 14, the patient’s Hb level increased to 6.5 g.dL_-1 with a hematocrit of 23%. The patient was discharged. Conclusions Use of Hb Raffimer as a bridge to recovery of this patient’s red blood cell mass may have prevented adverse clinical outcome. Because this product is a purified Hb solution devoid of other cellular components, it may be accepted as therapy by patients who, due to religious conviction, refuse allogeneic red blood cell transfusion. Objectif Décrire le traitement réussi d’une grave anémie aiguë avec un agent d’oxygénothérapie, un raffimère d’hémoglobine (Hb). éléments cliniques Une femme de 53 ans, témoin de Jéhovah, souffrait d’anémie sévère post-arthroplastie totale de la hanche. Elle refusait toute transfusion sanguine. De la tachycardie, de l’hypotension, des anomalies électrocardiographiques et des changements de l’état mental sont apparus avec une concentration d’Hb minimale de 3,2 g.dL_-1. Le raffimère d’Hb est une solution d’Hb humaine purifiée, polymérisée, développée comme substitut de l’Hb des globules rouges. Avec l’approbation, pour usage humanitaire, de la patiente, de la Food and Drug Administration et du Comité d’examen de l’institution, 2 L de raffimère d’Hb (Hemolink, Hemosol, Inc., Toronto, ON, Canada) ont été administrés avec du sulfate ferreux et de l’érythropoïétine humaine. L’Hb s’est élevée à 5,5 g.dL_-1 avec la résolution des symptômes. Pour assurer la récupération de la masse sanguine tout en maintenant le niveau d’Hb > 4,5 g.dL_-1, des doses additionnelles de 1000 mL de raffimère d’Hb ont été donnés aux jours trois, cinq et sept postopératoires (dose totale = 500 g d’Hb). Aucune complication sérieuse liée au raffimère d’Hb ne s’est développée. Au jour postopératoire 14, le niveau d’Hb est monté à 6,5 g.dL_-1 avec un hématocrite de 23 %. La patiente a reçu son congé. Conclusion Le raffimère d’Hb, utilisé pour favoriser la récupération de la masse sanguine peut avoir évité des complications cliniques. Cette solution d’Hb purifiée dépourvue d’autres composantes cellulaires peut constituer un traitement acceptable aux patients qui, par conviction religieuse, refusent une transfusion allogénique.
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use of Hemoglobin Raffimer for postoperative life threatening anemia in a jehovah s witness
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2005Co-Authors: Marcella J. Lanzinger, Laura E. Niklason, Michael Shannon, Steven E HillAbstract:Purpose To describe the successful treatment of acute, life-threatening anemia with the oxygen therapeutic agent, Hemoglobin (Hb) Raffimer.