Assessment of a 35% fluorocarbon emulsion

Area of Science:

• Biomedical Engineering
• Anesthesiology
• Critical Care Medicine

Background:

• Previous studies established the efficacy of 20% fluorocarbon emulsion (Fluosol-DA, 20%) as an oxygen carrier at high FIO2.
• Concerns exist regarding oxygen toxicity from prolonged exposure to FIO2 = 1.0.
• Oxygen content in fluorocarbons is proportional to FIO2 and concentration, suggesting higher concentrations can enable lower FIO2 use.

Purpose of the Study:

• To evaluate the hemodynamic and oxygen transport capabilities of a 35% fluorocarbon emulsion (Fluosol-DA, 35%) at a reduced FIO2 of 0.6.
• To determine if Fluosol-DA, 35% can maintain physiological parameters during exchange transfusion with decreasing hematocrit.

Main Methods:

• Five adult baboons underwent isovolemic total exchange transfusion with Fluosol-DA, 35% under mechanical ventilation at FIO2 = 0.6.
• Measurements of hemodynamics (MAP, HR, CO) and oxygen transport (O2 content, O2 delivery, VO2) were taken at decreasing hematocrit levels (20%, 10%, 5%, <2%).

Main Results:

• All animals survived the exchange transfusion.
• Total arterial oxygen content decreased significantly (p < 0.01) from 17.4 to 3.3 vol%.
• Oxygen delivery also significantly decreased (p < 0.01) from 21.8 to 5.1 cc/min-kg, yet MAP, HR, CO, and VO2 remained stable.

Conclusions:

• Fluosol-DA, 35% effectively supports hemodynamics and oxygen transport at an FIO2 of 0.6.
• This concentration allows for a safer reduced FIO2, mitigating risks associated with oxygen toxicity.
• Fluosol-DA, 35% demonstrates potential as a safe and effective acellular oxygen carrier.