Modern oxygen carriers: state of art 1990

Three major components of blood with clearly defined functions are: 1) red cells 2) plasma volume 3) coagulation factors At the present time artificial or synthetic coagulation factors are not available. Plasma volume expanders are well known in clinical practice. The main subject of this paper is the complex area of red cell substitutes with particular reference to the oxygen carrying capacity. The history of blood oxygen carrying capacity is briefly presented with particular reference to contributions by G. S. Adair, C. Bohr, M. Perutz and R. R. Benesch. 3 oxygen carrying developments are discussed in detail: 1) perfluorocarbons 2) artificial red cells 3) stroma-free haemoglobin solution Perfluorocarbons were used as carriers of oxygen in experiments and clinical practice. Before their wide clinical application a number of potential problems must be solved. In selected patients (coronary angioplasty, cerebral thrombosis, cardiopulmonary by-pass) perfluorocarbons (Fluosol D-A) could be considered as beneficial. Artificial red cells (neohaemocytes) are available in some centres in which progress of micro-technology appears to lead to encapsulation of purified human haemoglobin. These preparations should receive more attention. Finally stroma-free haemoglobin solution was the subject of our own research for several years. Our preparation met the requirements of the blood substitute, but had the short half-life in the circulation. Recent advances in chemistry in some centres resulted in the modification of hb molecule and linking with P-5-P. The modified poly hb solution is an ideal oxygen delivering fluid.