Oxygen-Carrying Solutions: An Overview

Abstract

While blood remains the optimal resuscitation fluid for anemic and hypovolemic shock, there are significant limitations to its use, including problems of availability; the high costs involved in obtaining, storing, crossmatching, and dispersing; and infectious and immunologic risks. Some of these problems have been alleviated by current techniques of processing plasma into purified albumin solutions. Such solutions, however, are expensive and do not transport additional oxygen. There is clearly a role for an artificial red cell substitute that will safely and effectively correct plasma volume deficits and transport oxygen. Not only would these solutions provide a cost-effective alternative to blood products, but they also would allow conservation of blood products for patients who most require them. The three avenues of research have been to develop purified modified hemoglobin solutions (stroma-free hemoglobin, SFH), emulsions of perfluorochemical liquids (PEC emulsions) and lipid encapsulation of either of these oxygen carriers.