Perfluorochemical oxygen carriers: potential uses in neurosciences

In this article we review recent developments in the field of "first-" and "second-generation" perfluorochemical (PFC) oxygen carriers. Particular emphasis is placed on the latest research and its implications regarding the clinical and experimental neurosciences. These compounds are ideally suited to the transportation of O2 within the vascular system. Two properties that facilitate their use in this respect are their very high solubility coefficients for O2 and CO2 and their biological inertness. Unfortunately, their widespread use has been limited by logistical difficulties associated particularly with their molecular behavior in vivo. However, advances in PFC technology have led to renewed interest. A potential role for second-generation PFCs in cerebral protection is exciting. Other possible significant applications are slowly becoming established in clinical practice. Currently under investigation are potential uses in the management of severe head injuries, radiotherapy or chemotherapy of malignant brain tumors, protection against air embolism, preservation of organs for transplantation, and as a tool in microsurgery of the retina or other parts of the CNS. Diagnostic neuroimaging applications could include the employment of PFCs as adjuncts in ultrasound, Doppler, computed tomography (CT), and magnetic resonance (MR) to achieve enhanced imaging and precise staging of inflammatory, neoplastic, and vascular disease processes. Research applications could include their use in magnetic resonance imaging and spectroscopy in assessing cerebral blood flow, local oxygen tension, and brain metabolism, in molecule-specific imaging, and as physiological markers of O2, ions, and pH.