| Tissue perfusion and oxygenation with blood substitutes. | |
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MedLine Citation:
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PMID: 10837788 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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As an alternative to transfusion of red blood cells, intravenously (iv) administered artificial oxygen (O(2)) carriers are intended to increase the reduced O(2) carrying capacity of blood in the case of acute severe anemia, i.e. hemorrhagic shock or extreme normovolemic hemodilution (ANH). Actually, two groups of artificial O(2) carriers are investigated: ultrapurified, stroma-free hemoglobin solutions (SFH) of human or bovine origin and synthetically produced perfluorocarbons (PFC). SFH may be administered in large amounts and are suitable for 1:1 replacement of blood losses in case of hemorrhage as well as for isovolemic exchange of blood during ANH. In both situations SFH solutions effectively restore (hemorrhagic shock) and maintain (extreme ANH) tissue oxygenation despite extremely low hematocrit values. The vasopressor property of the isolated Hb molecule leads to a species-dependent (rodent>pig>human) increase in systemic and pulmonary vascular resistance, but leaves overall distribution of cardiac output uninfluenced. Due to the particulate nature of PFC emulsions, iv administration has to be restricted to small doses (3-4.5 ml/kg body weight for the actually investigated 60% w/v perflubron emulsion) in order to avoid overload of the reticuloendothelial system. Thus PFC emulsions are unsuitable for isovolemic blood replacement in hemorrhagic shock or ANH. Low-dose iv PFC administration in already hemodiluted subjects, however, creates an additional margin of safety to guarantee adequate tissue oxygenation which allows for further, extreme ANH, without risking tissue hypoxia. |
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Authors:
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O P Habler; K F Messmer |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Advanced drug delivery reviews Volume: 40 ISSN: 0169-409X ISO Abbreviation: Adv. Drug Deliv. Rev. Publication Date: 2000 Feb |
Date Detail:
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Created Date: 2000-07-18 Completed Date: 2000-07-18 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8710523 Medline TA: Adv Drug Deliv Rev Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 171-84 Citation Subset: IM |
Affiliation:
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Institute of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany. habler@icf.med.uni-muenchen.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Substitutes / administration & dosage, pharmacology* Cattle Humans Oxygen / blood* Oxygen Consumption / drug effects* Perfusion |
| Chemical | |
Reg. No./Substance:
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0/Blood Substitutes; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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