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The ideal hemoglobin-based blood substitute (HBBS) would have a long shelf life without refrigeration, not require crossmatching, eliminate the risk for transfusion-induced infection, and not pose a threat to any organs. Although the products tested to date differ in how the hemoglobin moieties are linked or carried, they all include hemoglobin molecules that do not contain red-cell membranes. Thus, the molecules rapidly scavenge nitrous oxide when released into the bloodstream, which can cause systemic and cardiac vasoconstriction, increased release of proinflammatory mediators and other vasoconstrictors, and loss of platelet inactivation.
To determine the safety of HBBSs in adult surgery, stroke, and trauma patients, researchers conducted …