Gould S A, Rosen A L, Sehgal L R, Sehgal H L, Langdale L A, Krause L M, Rice C L, Chamberlin W H, Moss G S
N Engl J Med. 1986 Jun 26;314(26):1653-6. doi: 10.1056/NEJM198606263142601.
We assessed the safety and efficacy of Fluosol-DA as a red-cell substitute in acute anemia. Twenty-three surgical patients with blood loss and religious objections to receiving blood transfusions were evaluated. Fifteen moderately anemic patients with a mean hemoglobin level (+/- SE) of 7.2 +/- 0.5 g per deciliter had no evidence of a physiologic need for increased arterial oxygen content and did not receive Fluosol-DA. Eight severely anemic patients with a mean hemoglobin level of 3.0 +/- 0.4 g per deciliter met the criteria of need and received the drug until the physiologic need disappeared or a maximal dose of 40 ml per kilogram of body weight was reached. We observed no adverse reactions to Fluosol-DA. The average peak increment in arterial oxygen content with the drug was only 0.7 +/- 0.1 ml per deciliter. There were no appreciable beneficial effects of Fluosol-DA, perhaps because of the small increase in arterial oxygen content, the brief half-life of the drug (24.3 +/- 4.3 hours), and the limited total dose. Six of the eight patients receiving Fluosol-DA died. One of the survivors received red-cell transfusions against his wishes, under a court order, after his total Fluosol-DA dose. Fourteen of the 15 moderately anemic patients survived. The data in this select group of patients refusing blood products suggest that, after blood loss, Fluosol-DA is unnecessary in moderate anemia and ineffective in severe anemia.
我们评估了氟碳化合物乳剂（Fluosol-DA）作为急性贫血时红细胞替代物的安全性和有效性。对23例因失血且出于宗教原因拒绝接受输血的外科手术患者进行了评估。15例中度贫血患者，平均血红蛋白水平（±标准误）为每分升7.2±0.5克，没有证据表明其生理上需要增加动脉血氧含量，因此未接受氟碳化合物乳剂。8例重度贫血患者，平均血红蛋白水平为每分升3.0±0.4克，符合用药标准并接受了该药治疗，直至生理需求消失或达到每千克体重40毫升的最大剂量。我们未观察到氟碳化合物乳剂的不良反应。用药后动脉血氧含量的平均峰值仅增加了每分升0.7±0.1毫升。氟碳化合物乳剂没有明显的有益效果，这可能是由于动脉血氧含量增加幅度小、药物半衰期短（24.3±4.3小时）以及总剂量有限。接受氟碳化合物乳剂治疗的8例患者中有6例死亡。一名幸存者在接受完氟碳化合物乳剂的总剂量后，根据法庭命令违背其意愿接受了红细胞输血。15例中度贫血患者中有14例存活。这组拒绝输血制品的特定患者的数据表明，失血后，氟碳化合物乳剂对中度贫血患者不必要，对重度贫血患者无效。
