Safety and preliminary efficacy of hemoglobin raffimer for patients undergoing coronary artery bypass surgery.

Published

Journal Article

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.

Full Text

Cited Authors

  • Hill, SE; Gottschalk, LI; Grichnik, K

Published Date

  • December 2002

Published In

Volume / Issue

  • 16 / 6

Start / End Page

  • 695 - 702

PubMed ID

  • 12486649

Pubmed Central ID

  • 12486649

International Standard Serial Number (ISSN)

  • 1053-0770

Digital Object Identifier (DOI)

  • 10.1053/jcan.2002.128416

Language

  • eng

Conference Location

  • United States