PERFLUOROCHEMICAL-BASED ARTIFICIAL OXYGEN-CARRYING RED-CELL SUBSTITUTES

There has been rapid progress in research on artificial oxygen-carryin g red blood cell substitutes composed of perfluorochemical emulsions ( PFE). PFE are capable of delivering significant amounts of oxygen to t issues, but FDA approval is given for routine human use they must firs t overcome concerns regarding adverse effects and then clearly demonst rate efficacy in human trials. Infusion of the first commercial produc t used in humans, Fluosol-DA(TM), which contained a relatively low con centration of perfluorochemical, was associated with immediate adverse effects in some individuals and failed to demonstrate efficacy in a p rospective clinical trial. A second generation PFE artificial oxygen c arrier, Oxygent-HTTM, should be more effective since it carries five-f old more oxygen than Fluosol, does not require mixing, and is more sta ble. Initial clinical trials of this and other second generation PFE w ere accompanied by mild, transient flu-like side effects. PFE are also being investigated for regional organ perfusion, tumor oxygenation pr ior to radiotherapy, contrast imaging, and for liquid ventilation of i nfants with respiratory distress syndrome. The development of a safe, effective, artificial oxygen carrier at reasonable cost will have a ma jor effect on transition practice. Since PFE have a brief intravascula r survival they are unlikely to supplant the use of red blood cells in treatment of anemia.