PERFLUOROCARBONS AS BLOOD SUBSTITUTES - EARLY YEARS - EXPERIENCE WITHFLUOSOL DA-20-PERCENT IN THE 1980S

Clinical testing of perfluorocarbons (PFC) as blood substitutes began in the early 1980's in the form of Fluosol DA-20% (FDA), a mixture of perfluorodecalin and perfluorotripropylamine emulsified with Pluronic F68. We have treated 55 patients (Treatment (T) = 40; Control (C) = 15 ) with intravenous infusions of 30 cc/kg of FDA as part of either a ra ndomized, clinical trial or a humanitarian protocol. All patients were Jehovah's Witnesses who refused blood transfusion and were severely a nemic ( mean hemoglobin = 4.6 g/d). FDA successfully increased dissolv ed or plasma oxygen content (P102 in ml/dl), but not overall oxygen co ntent (T group: P102 baseline = 1.01+/-.27, P102 12hrs = 1.58+/-.47 [p =<.0001, t-test]; P102 12hrs: T=1.58+/-.47, C= 1.00+/-.31, p=<.0002, t -test). This effect persisted for only 12 hours post infusion, and had no apparent effect on survival. FDA is an ineffective blood substitut e because of low concentration and short half-life. Improved emulsion design may resolve these problems, thereby producing a more effective agent. Our discussion will include a review of our data plus a summary of other reports of FDA efficacy as a blood substitute.