the present invention describes novel neuroprotective and multifunctional intra - and inter - molecular redox coupled polynitroxylated pegylated carboxy hemoglobins as high therapeutic index agents for un - met medical needs or diseases , which require acute or chronic alleviation of oxidative stress and correction of inadequate blood flow resulting from physical injury , ischemia , reperfusion injury , and inflammation injury in either or both pre - hospital and in - hospital transfusion and critical care medicine . these hemoglobins are triple - modified with a focus on therapeutic activities rather than oxygen carrying ability .