[Clinical evaluation of artificial blood substitute (fluosol-DA 20%) in patients of cerebral ischemia].

The efficacy of perfluorochemicals (Fluosol-DA 20%) as an erythrocyte substitute and the changes of regional cerebral blood flow (r-CBF) following the administration of Fluosol-DA were studied. Seventy-three patients suffering from cerebral ischemic diseases were treated by 10 m/kg of Fluosol-DA. Intravenous infusions were performed 126 times. Clinical efficacy could be estimated by neurological signs, r-CBF and EEG findings in 53 patients who were in acute or subacute stage of diseases. These patients were classified into three groups; 1) Vasospasm group consists of 21 patients and 43 times of infusion, 2) Stenosis or occlusion group consists of 21 patients and 29 times of infusion, and 3) Others. Improvement occurred in 65.1% and 65.5% of vasospasm, and occlusion group, respectively. No aggravated case was noted. One out of 126 infusions showed an exanthema. Changes of r-CBF was measured in 20 cases on 32 hemispheres by either inhalation or intra-arterial infection of 133Xenon. r-CBF was increased 25.0% after the administration of Fluosol-DA when measured by intraarterial injection of 133Xenon. The increase of 16.9% in r-CBF was found in 11 cases by the inhalation method. These values were well correlated with that of animal study using monkeys measured by hydrogen clearance method. From the comparison of the effect of Fluosol-DA and Hespander on r-CBF, the mechanism of increased r-CBF by Fluosol-DA 20%, which contains 2.9% of hydroxyethyl-starch, was considered to be not solely due to the lowering of blood viscosities but also due to the dilating effect on cerebral vessels.