To the Editor: Dr Natanson and colleagues1 published a meta-analysis attempting to compare the safety profile for 5 different HBOCs. They pooled adverse event data for MI and death from 16 diverse trials conducted from 1997 to 2007, with study populations ranging from 10 to more than 700 patients in a variety of cardiac, orthopedic, vascular, ischemic stroke, and trauma patient populations. The majority of data came from earlier generation products, including HemAssist (Baxter Healthcare, Deerfield, Illinois) and Hemolink (Hemosol Inc, Mississauga, Ontario, Canada), which were discontinued in 1998 and in 2004, respectively; Hemopure (Biopure); and PolyHeme (Northfield Laboratories, Evanston, Illinois). The pooled analysis concluded that HBOCs were associated with a significantly increased risk of death and MI.
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