Resuscitation of an exsanguinated obstetrics patient with HBOC-201: A case report

Christopher D. Barrett, Sheina Theodore, Tracey Dechert, Peter Burke, Rasha Khoury, Andrew P. Cap, Dane Scantling*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Hemorrhagic shock is a clinically challenging disease process with high mortality. When conventional blood products are unable to be administered, oxygen-carrying blood alternatives are sometimes utilized. The international experience with this scenario is limited. We aim to add to this body of literature. Study Design and Methods: This is a case report of the administration of bovine hemoglobin-based oxygen-carrying red blood cell (RBC) substitute HBOC-201 (HemoPure®) to a patient with post-partum bleeding and hemorrhagic shock because the patient declined RBC transfusion. HBOC-201 was administered with consent under a one-time Emergency Investigational New Drug (eIND) approval from the Food and Drug Administration with appropriate notification of the Institutional Review Board. Results: The patient was successfully resuscitated with HBOC-201 from hemorrhagic shock. She was weaned off of vasopressor support and extubated with the recovery of her baseline mental status within 4 h. However, approximately 36 h after this, the patient developed multi-organ system dysfunction, volume overload, right heart failure and ultimately expired early on post-partum day 4. Discussion: Resuscitation from hemorrhagic shock with HBOC-201 as an RBC alternative is feasible, but significant challenges remain with the management of sequelae resulting from prolonged low-flow, ischemic states as well as the significant colloid pressure and volume overload experienced after massive transfusion with an acellular colloid oxygen carrier.

Original languageEnglish
Pages (from-to)S218-S223
Issue numberS1
StatePublished - Aug 2022
Externally publishedYes


  • HBOC-201
  • bleeding
  • exsanguination
  • resuscitation


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