Mitsuno T, Ohyanagi H, Yokoyama K, Suyama T
Kasuga Memorial Hospital, Kobe, Japan.
Biomater Artif Cells Artif Organs. 1988;16(1-3):365-73. doi: 10.3109/10731198809132587.
In summary, we have discussed PFC emulsions as oxygen carriers, and concluded as follows: PFC emulsions which are clinically usable at present, such as Fluosol-DA, have some negative points. For instance, there is the requirement of relatively high FiO2 level, short retention time in the blood stream, slow excretion rate from the organs, limited dosage for infusion, and so on. However, in the clinical cases of moderate acute anemia, the consumed oxygen in the PFC phase was nearly 30% of that in the hemoglobin phase in the administration of only 1,000 ml of Fluosol-DA. It strongly suggests that PFC emulsion can carry a considerable amount of oxygen to the tissues and play an important role in improving the tissue hypoxia. Moreover, we surgeons wish to say that there is a great difference for the surgeons' mental state during a surgical operation between the cases where no blood transfusion is allowed for a religious or other reason, and the cases where we may use Fluosol-DA depending on the patients' condition. In the former cases, surgeons will be under stress such that he or she might cause the patients to lose blood excessively. On the other hand, when the surgeon has something in reserve, that is, when he or she may use Fluosol-DA if needed, a good result will usually be obtained in the operation, even without actually using Fluosol-DA. One might be led to say that a key point for the success of operations is the surgeon's mental condition, freedom from anxiety.(ABSTRACT TRUNCATED AT 250 WORDS)
总之,我们讨论了作为氧载体的全氟碳化合物(PFC)乳剂,并得出以下结论:目前临床上可用的PFC乳剂,如氟碳乳剂(Fluosol-DA),存在一些缺点。例如,需要相对较高的吸入氧分数(FiO2)水平,在血流中的保留时间短,从器官排出的速率慢,输注剂量有限等。然而,在中度急性贫血的临床病例中,仅给予1000ml氟碳乳剂时,PFC阶段消耗的氧气几乎是血红蛋白阶段的30%。这有力地表明,PFC乳剂可以向组织输送相当数量的氧气,并在改善组织缺氧方面发挥重要作用。此外,我们外科医生想说,在手术过程中,由于宗教或其他原因不允许输血的情况与根据患者情况可以使用氟碳乳剂的情况相比,外科医生的精神状态有很大差异。在前一种情况下,外科医生会承受压力,以至于可能导致患者失血过多。另一方面,当外科医生有所储备,即如果需要可以使用氟碳乳剂时,即使实际上没有使用氟碳乳剂,手术通常也会取得良好的效果。有人可能会说手术成功的关键在于外科医生的精神状态,即没有焦虑。(摘要截断于250字)