Effect of exchange transfusion with a red blood cell substitute on the neonatal lung

The present study was designed to evaluate the acute effects of a perfluorocarbon erythrocyte substitute on cardiopulmonary function in the newborn lamb. Isovolemic double volume exchange transfusions were performed with the perfluorocarbon emulsion (FC-43) during controlled ventilation and acid-base status. Cardiopulmonary function was determined pre (control) and post (exchange) exchange transfusion. As expected with perfluorocarbon transfusion, hematocrit decreased (from 31.3 +/- 1.35% to 6.7 +/- 0.8%, SEM, P less than 0.001) and fluorocrit increased (from 0 to 17.8 +/- 2%, P less than 0.001). These changes in blood composition were associated with a significant increase in arterial oxygen tension (from 317.0 +/- 22 mmHg to 419.0 +/- 22 mmHg, P less than 0.001) and decrease in arterial oxygen content (from 14.0 +/- 8 ml O2/dl blood + PFC to 5.4 +/- 0.3 ml O2/dl blood + PFC, P less than 0.001), A-a oxygen gradient (from 357.0 +/- 23 mmHg to 255.0 +/- 23 mmHg, P less than 0.001) and viscosity (from 3.4 +/- 0.1 cps to 2.1 +/- 0.1 cps, P less than 0.001). No significant change in lung mechanics or hemodynamics was observed. These preliminary data demonstrate cardiopulmonary and hemodynamic stability immediately following transfusion with perfluorocarbon emulsion and outline physiological responses associated with transfusion of perfluorocarbon emulsions, a potential adjunct to neonatal therapeutics.