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October 4, 1976

Coagulation Studies During Experimental Hemoglobinemia

Author Affiliations

Pittsfield, Mass

JAMA. 1976;236(14):1575-1576. doi:10.1001/jama.1976.03270150013008

To the Editor.—  I read with great interest the article entitled "Benign Hemoglobinuria Following Transfusion of Accidentally Frozen Blood" (235:2850-2851, 1976). The conclusion drawn was that the benign clinical response to the presence of massive hemoglobinuria was attributable to the absence of immunologic incompatibility, thus failing to activate mediators of disseminated intravascular coagulation. In relation to this point and to support it I refer to our previous studies in humans, in which either a bolus injection of 100 ml autologous frozen thawed blood was infused in ten minutes or a 50-ml bolus was infused in three to four minutes followed by a continuous five-hour infusion.1 In 14 studies in which the plasma hemoglobin levels in the human volunteers were in the range of 250 mg/100 ml, there was no evidence of disseminated intravascular coagulation. The mean peak plasma hemoglobin level following this single bolus injection was 540 mg/100 ml. We