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Cell-Free Hemoglobin in the Pathophysiology of Trauma: A Scoping Review

Overview
Journal Crit Care Explor
Specialty Critical Care
Date 2024 Feb 14
PMID 38352942
Authors
James T Ross
Anamaria J Robles
Monty B Mazer
Amy C Studer
Kenneth E Remy
Rachael A Callcut
Affiliations
Soon will be listed here.
Abstract

Objectives: Cell-free hemoglobin (CFH) is a potent mediator of endothelial dysfunction, organ injury, coagulopathy, and immunomodulation in hemolysis. These mechanisms have been demonstrated in patients with sepsis, hemoglobinopathies, and those receiving transfusions. However, less is known about the role of CFH in the pathophysiology of trauma, despite the release of equivalent levels of free hemoglobin.

Data Sources: Ovid MEDLINE, Embase, Web of Science Core Collection, and BIOSIS Previews were searched up to January 21, 2023, using key terms related to free hemoglobin and trauma.

Data Extraction: Two independent reviewers selected studies focused on hemolysis in trauma patients, hemoglobin breakdown products, hemoglobin-mediated injury in trauma, transfusion, sepsis, or therapeutics.

Data Synthesis: Data from the selected studies and their references were synthesized into a narrative review.

Conclusions: Free hemoglobin likely plays a role in endothelial dysfunction, organ injury, coagulopathy, and immune dysfunction in polytrauma. This is a compelling area of investigation as multiple existing therapeutics effectively block these pathways.

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