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Previous Volume 343:1273 October 26, 2000 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In their encouraging report of the use of a bovine hemoglobin solution, HBOC-201, to sustain life when red-cell transfusion was impossible, Mullon et al. (June 1 issue)¹ discuss the possible role of HBOC-201 in promoting an episode of severe gram-negative sepsis. We wish to suggest a mechanism by which cell-free hemoglobin may increase the pathophysiologic effects of sepsis.

Gram-negative bacteria can shed outer-wall material containing lipopolysaccharide (bacterial endotoxin) into the bloodstream. Lipopolysaccharide causes much of the toxicity associated with gram-negative bacterial sepsis and produces a state of clinical sepsis indistinguishable from that produced by live bacteria. We² . . . [Full Text of this Article]

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