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Increasing Hemoglobin Concentration With An Artificial Oxygen Carrier Improves Severe Anemia-Induced Degraded Cognitive Function.

ABSTRACT
Prior to death patients commonly experience impaired consciousness for a significant period of time, frequently preventing family and others from final interactions with the patient. Some of these episodes of cognitive impairment may be treatable, with treatment not offered owing to the perception of ultimate futility, or expense, or both. One of the causes of terminal loss of consciousness or decreased lucidity can be inadequate cerebral oxygen delivery. Methods and We report five cases from four institutions where an infusion of a hemoglobin-based oxygen carrier (HBOC) to patients who were unconscious or not lucid owing to acute severe anemia (hemoglobin range 2.1 - 5.2 g/dL) resulted in awakening or lucidity. We review briefly human cognitive function and anemia, and remark about the use of an HBOC for acute severe anemia when red cell transfusion is not an option.