Myocardial infarction blood substitutes

Natanson C, Kern SJ, Lurie P, Ranks SM, Wolfe SM. Cell-free hemoglobin-based blood substitutes and risk of myocardial infarction and death a meta-analysis. JAMA 2008 299(19) 2304-12. 

Blood substitutes were critically reviewed by Chen et al. [23] who reached the conclusion Published animal studies and clinical trials carried out in a perioperative setting have demonstrated that these products successfully transport and deliver oxygen, but all may induce hypertension and lead to unexpectedly low cardiac outputs. Overall, these studies suggest that HBOCs resulted in only modest blood saving during and after surgery, no improvement in mortality and an increased incidence of adverse reactions (p. 803). This assertion is supported by findings of the meta-analysis of Natanson et al. [57] who found that clinical trials associated with blood substitutes increased the risk of mortality by 30% and myocardial infarction 2.7-fold. 

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