PERFLUOROCARBONS - RECENT DEVELOPMENTS AND IMPLICATIONS FOR NEUROSURGERY

Over the last 30 years, perfluorocarbons (PFCs) have been extensively investigated as oxygen carriers. Early studies indicated that these co mpounds could be used as blood substitutes or protective agents agains t ischemia. Adverse characteristics such as instability, short intrava scular half-life, and uncertainties concerning possible toxicity precl uded wide clinical application. However, advances in PFC technology ha ve led to the development of improved second-generation oxygen carrier s that incorporate well-tolerated emulsifiers (egg-yolk phospholipids) . The authors review recent developments in this field and consider th e potential role of PFCs in future neurosurgical practice. Diagnostic applications could include their use to assess cerebral blood flow, lo cal oxygen tension, and brain metabolism or to achieve enhanced imagin g and precise staging of inflammatory, neoplastic, or vascular disease processes by means of computerized tomography, ultrasonography, and m agnetic resonance studies. Therapeutic applications could include cere bral protection, an adjunctive role in radiotherapy of malignant brain tumors, protection against air embolism, the preservation of organs f or transplantation, and ventilatory support in head-injured patients w ith compromised lung function. In addition, PFCs have been used succes sfully as a tool in ophthalmic microsurgery and potentially thy could fulfill a similar role in microneurosurgery.