Initial Canadian experience with artificial blood (Fluosol-DA-20%) in severely anemic patients

Fluosol-DA-20% (FDA), a synthetic perfluorocarbon emulsion with oxygen (O2) carrying capability, has recently become available in North America for clinical trials in severely anemic patients. Three patients have so far received FDA at our institution. All were severely anemic (Hct's 12-15%), and were administered FDA in anticipation of perioperative blood loss. Observations made in these patients indicate that: FDA can act as a plasma expander; no firm conclusions can be made as to whether FDA increases O2 consumption in the absence of directly measured arterial and mixed-venous O2 contents; mixed-venous oxyhemoglobin saturation at high FiO2 increases following FDA administration because a significant proportion of the consumed O2 (24-37% in our patients at FiO2 = 1.0) is transported by FDA; hemodynamic reactions to a test dose of FDA may occur, and may be serious enough to preclude further FDA administration; and technical recommendations for the administration of FDA should include the use of direct arterial and mixed-venous O2-content determinations, and continuous spectrophotometric mixed-venous oxyhemoglobin saturation monitoring.