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Related Experiment Videos

Current status of injectable oxygen carriers

T F Zuck1, J G Riess

  • 1Hoxworth Blood Center, University of Cincinnati, Ohio.

Critical Reviews in Clinical Laboratory Sciences
|January 1, 1994
PubMed
Summary

Blood substitutes, based on hemoglobin or perfluorochemicals, are being developed for oxygen transport but do not replace all blood functions. Proving their clinical benefit over volume replacement presents challenges for FDA approval.

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Area of Science:

  • Biomedical Engineering
  • Hematology
  • Pharmacology

Background:

  • Current
  • blood substitute
  • formulations aim to transport oxygen but lack essential blood functions.
  • Hemoglobin-based and perfluorochemical-based oxygen carriers are under development.
  • Regulatory approval by the Food and Drug Administration (FDA) requires demonstrated efficacy and safety.

Purpose of the Study:

  • To review the current status of blood substitute development.
  • To discuss the advantages and disadvantages of hemoglobin and perfluorochemical bases.
  • To address the challenges in proving clinical efficacy compared to volume replacement.

Main Methods:

  • Review of existing literature on hemoglobin-based oxygen carriers (HBOCs) and perfluorochemicals (PFCs).
  • Discussion of challenges in efficacy models, such as perioperative hemodilution.
  • Analysis of modifications to HBOCs to improve oxygen dissociation and intravascular dwell time.
  • Examination of PFC properties, administration as emulsions, and excretion.

Main Results:

  • HBOCs face challenges with altered oxygen dissociation curves and rapid renal clearance of dimers.
  • Chemical modifications of HBOCs have improved p50 and dwell time, but toxicity concerns, including nitric oxide binding and hypertension, persist.
  • PFCs offer a simpler oxygen transport mechanism, relying on the recipient's inspired oxygen and cardiac output.
  • PFCs are administered as emulsions and excreted unchanged via the lungs after storage in the monocyte-macrophage system.

Conclusions:

  • Blood substitutes are not true replacements for blood due to functional limitations.
  • Overcoming challenges in efficacy demonstration and resolving toxicity issues are crucial for clinical adoption.
  • Both HBOCs and PFCs present distinct advantages and disadvantages that require further research and development.

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