Habler O, Kleen M, Messmer K
Institut für Chirurgische Forschung, Ludwig-Maximilians-Universität München.
Zentralbl Chir. 1999;124(4):260-70.
The expected explosion of costs in transfusion medicine due to the shortfall of healthy donors and the more frequent treatment of transfusion-associated complications (chronic hepatitis, cirrhosis, wound infection, tumor recurrence) increases the socio-economic importance of the development of safe and effective synthetic oxygen carriers as an alternative to the transfusion of homologous red blood cells. Currently two types of artificial oxygen carriers are experimentally and clinically investigated for their capacity to ensure adequate tissue oxygenation in the case of severe anemia. In addition to their oxygen transport capacity solutions based on free human or bovine hemoglobin provide vasoconstrictor properties. Their hyperoncotic properties make them particularly attractive for the treatment of severe hemorrhagic shock. Perfluorocarbon (PFC) emulsions allow an increase of the physically dissolved portion of arterial oxygen content. Due to their particulate nature (emulsion droplets) PFC may only be infused in low doses. Otherwise there is risk of overload and malfunction of phagocytic cells of the reticulo-endothelial system. In the case of an intraoperative blood-loss in preoperatively hemodiluted patients, bolus infusion of PFC represents an effective means to avoid immediate retransfusion of autologous blood and allows for further, extreme hemodilution without risking tissue hypoxia.
由于健康供血者短缺以及输血相关并发症（慢性肝炎、肝硬化、伤口感染、肿瘤复发）治疗愈发频繁，输血医学领域预计成本将大幅增加，这凸显了开发安全有效的合成氧载体作为同源红细胞输血替代品的社会经济重要性。目前，两种人工氧载体正在进行实验和临床研究，以评估其在严重贫血情况下确保组织充分氧合的能力。除了氧运输能力外，基于游离人血红蛋白或牛血红蛋白的溶液还具有血管收缩特性。它们的高渗特性使其在治疗严重失血性休克方面特别有吸引力。全氟碳（PFC）乳剂可增加动脉血氧含量的物理溶解部分。由于其颗粒性质（乳剂滴），PFC只能低剂量输注。否则，存在网状内皮系统吞噬细胞过载和功能障碍的风险。对于术前进行血液稀释的患者，术中失血时大剂量输注PFC是避免立即回输自体血的有效方法，并且可以进一步进行极度血液稀释而不危及组织缺氧。
