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[Artificial blood substitutes ]

H Förster1

  • 1Abteilung II, Universitätsklinikum Frankfurt/Main.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|December 1, 1994
PubMed
Summary

Researchers explored artificial blood substitutes for gas transport and colloid osmotic pressure. Hemoglobin derivatives and fluorocarbons show promise but face challenges, while hydroxyethyl starch is a favored colloid substitute.

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Area of Science:

  • Biomedical Engineering
  • Hematology
  • Pharmacology

Context:

  • Blood substitutes are crucial for medical applications requiring oxygen delivery or volume expansion.
  • Current research focuses on overcoming limitations of existing artificial blood products.
  • The study reviews two main strategies: hemoglobin-based oxygen carriers and synthetic colloids.

Purpose:

  • To evaluate the efficacy and limitations of hemoglobin derivatives and fluorocarbons as oxygen carriers.
  • To assess the clinical utility of synthetic colloids in replacing albumin for volume expansion.
  • To provide an overview of the current status and future prospects of blood substitute research.

Summary:

  • Hemoglobin-based oxygen carriers, modified via pyridoxal phosphate coupling or cross-linking, face challenges with oxygen release and stability.
  • Fluorocarbons offer physical gas transport but require high oxygen partial pressures and have elimination issues.
  • Synthetic colloids like hydroxyethyl starch (HES) are used to maintain colloid osmotic pressure and improve hemodynamics, with HES being preferred in Germany due to fewer side effects compared to dextran and gelatin.

Impact:

  • Identifies key hurdles in developing effective hemoglobin-based and fluorocarbon-based blood substitutes.
  • Highlights hydroxyethyl starch as a clinically relevant and well-tolerated albumin substitute.
  • Suggests that widespread clinical use of advanced hemoglobin derivatives and fluorocarbons is unlikely in the near future, while optimized hydrocolloids remain important.

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