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Fluosol: therapeutic failure in severe anemia
P B Kale1, G E Sklar, L A Wesolowicz
1Department of Pharmacy Practice, Wayne State University, Detroit, MI.
Objective:
To report the use of Fluosol in the management of a severe anemia and to review the literature regarding the use of Fluosol.
Case Report:
A 40-year-old woman, at 40.5 weeks gestation, was admitted for induction of labor. Her hospital course was complicated by a postpartum hemorrhage and severe anemia. Because the patient was a Jehovah's Witness, she received non-blood products including hetastarch, iron dextran, and erythropoietin, and a total of 33 mL/kg of Fluosol, but she did not survive.
Discussion:
Fluosol is an oxygen-carrying, perfluorochemical blood substitute. It was administered to our patient, who presented with the lowest hemoglobin (Hb) (11 g/L) and hematocrit (0.31 fraction of 1.00) of all reported cases. Almost all patients with an Hb < 20 g/L do not survive.
Conclusions:
Although the use of Fluosol as a blood substitute appears theoretically promising, its use in the management of severe anemia cannot be recommended.