Fluosol-DA: an artificial blood for total cardiopulmonary bypass.

The isolated, in situ pig heart model was used to determine if Fluosol could support myocardial function during cardiopulmonary bypass. Fourteen pigs were utilized; 7 underwent studies of myocardial metabolism (coronary blood flow and vascular resistance, myocardial oxygen consumption and extraction, lactate extraction, and adenosine triphosphate and creatine phosphate levels), and 7 underwent studies of myocardial contractility and compliance (intraventricular balloon measurements). Each study was carried out utilizing one hour of control hemic perfusion, followed by one hour of Fluosol perfusion, and followed by a third hour of a return of hemic perfusion. The results documented that in the vented, beating, nonischemic heart, myocardial metabolism and functional measurements are maintained during an hour of Fluosol perfusion. However, because of an increased level of ionized calcium during Fluosol perfusion, myocardial functional measurements document significantly increased contractility. The increased contractility is associated with an increase in anaerobic metabolism. The latter contributes to a decline in the high-energy phosphate level following a return of hemic perfusion as the heart recovers from the increased work load placed on it during Fluosol perfusion. It is concluded that here is sufficient oxygen-carrying capacity in Fluosol-DA to maintain cardiac function during perfusion in the large animal model. However, the carrier solution for the Fluosol must be adjusted to appropriate electrolyte content to avoid adverse effects on the myocardium.