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Updated: Aug 24, 2026

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Published on: May 8, 2026
Use of a hemoglobin-based oxygen carrier in the treatment of severe anemia
Aryeh Shander1, Raed Alalawi, Petra Seeber
1Department of Anesthesiology and Critical Care Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey 07631, USA. aryeh.shander@ehmc.com
Background:
Hemoglobin-based oxygen carriers hold promise for the treatment of acute anemia.
Case:
We report a patient with severe dysfunctional uterine bleeding. During her hospitalization, her lowest hemoglobin level was 3.1 g/dL, with a hematocrit of 9.3%. An investigational product, o-raffinose cross-linked human hemoglobin solution (hemoglobin raffimer), was infused along with ongoing high-dose recombinant human erythropoietin and estrogen. The time until the patient's own hematopoiesis provided sufficient red blood cell mass was successfully managed by reducing oxygen demand and providing multiple hemoglobin-based oxygen carrier infusions. After hemoglobin-based oxygen carrier administration, transient pulmonary hypertension and fever were noted. She was discharged after corrective surgery 7 days after hemoglobin-based oxygen carrier administration with a hemoglobin level of 7.8 g/dL.
Conclusion:
The hemoglobin level-based oxygen carrier improved oxygen delivery and permitted uterine corrective surgery.
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