-
Current Opinion in Hematology Mar 2002Blood substitutes are solutions intended to replace transfusion of banked red blood cells. Several variations of products based on either hemoglobin (animal or human) or... (Review)
Review
Blood substitutes are solutions intended to replace transfusion of banked red blood cells. Several variations of products based on either hemoglobin (animal or human) or perfluorocarbon emulsions are in advanced stages of clinical development. The need for such products is pressing as shortages of banked blood worsen and awareness of the dangers of blood transfusion increases. Animal and human studies with these cell-free oxygen carriers have led to new concepts of how oxygen is delivered to tissue and how the microcirculation is regulated. Although development of products is exciting and timely, understanding how they function to perfuse and oxygenate tissue could be at least as important. Because cell-free oxygen carriers will perfuse every organ of the body, their effects are far-reaching, and the transition from the laboratory to the bedside can be expected to be slow and deliberate. Comparison of oxygen carriers with more traditional starch-based products provides new insight into the interaction of oxygen transport, microvascular perfusion, and blood volume expansion.
Topics: Animals; Blood Substitutes; Hemodynamics; Hemorheology; Humans; Oxygen
PubMed: 11844999
DOI: 10.1097/00062752-200203000-00011 -
Advanced Drug Delivery Reviews Feb 2000Red cell substitutes are a group of oxygen carriers designed to temporarily replace transfused blood. Each product is unique in its limitations and advantages. Research... (Review)
Review
Red cell substitutes are a group of oxygen carriers designed to temporarily replace transfused blood. Each product is unique in its limitations and advantages. Research and development has been slow because of the far-reaching consequences of replacing an oxygen carrier outside of the red cell. Nevertheless, a number of products are in advanced clinical trials and nearing the market. When they are available for use it is likely that development will accelerate and even better products will substantially alleviate the world-wide shortage of blood for transfusion and enable the delivery of medical care to underserved populations. An important consequence of the development of these products has been a better understanding of how oxygen is delivered to tissues.
Topics: Animals; Blood Substitutes; Blood Transfusion; Humans
PubMed: 10837785
DOI: 10.1016/s0169-409x(99)00045-9 -
Journal of the Royal Army Medical Corps Mar 2007
Review
Topics: Blood Substitutes; Humans; Military Medicine; United Kingdom
PubMed: 17575868
DOI: 10.1136/jramc-153-01-02 -
Critical Reviews in Oncology/hematology 1987The salient physicochemical properties of the fluorocarbons are briefly reviewed, including their solubility for the physiologically important gases and their properties... (Review)
Review
The salient physicochemical properties of the fluorocarbons are briefly reviewed, including their solubility for the physiologically important gases and their properties relevant to formulation (nonmiscibility with water). The preparations used to date are described, including their properties and compositions, with some comment about the available knowledge of the properties of the constituents. A critical review of the biological aspects and the possible uses of fluorocarbon emulsions constitutes the main body of the manuscript. Gas-transporting capabilities are considered quantitatively. The biological effects of these preparations are reviewed in in vivo, whole body systems, with some in vitro evidence where appropriate. The usefulness of these preparations investigated to date are reviewed under the broad headings of cardiovascular system, radiology, intoxications, and organ preservation. Finally, the shortcomings and potential usefulness are discussed, with recommendations for potential modifications.
Topics: Biological Transport; Blood Substitutes; Chemical Phenomena; Chemistry; Chemistry, Physical; Drug Administration Schedule; Fluorocarbons; Gases; Hemorrhage; Humans; Inactivation, Metabolic; Infusions, Parenteral; Ischemia; Neoplasms
PubMed: 3549022
DOI: 10.1016/s1040-8428(87)80018-5 -
Transfusion Science Jul 1992
Review
Topics: Blood Substitutes; Blood Transfusion; Colloids; Fluorocarbons; Hemoglobins; Humans
PubMed: 10148132
DOI: 10.1016/0955-3886(92)90148-A -
Cardiovascular & Hematological Agents... 2019Artificial blood is an innovative concept of transfusion medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body...
Artificial blood is an innovative concept of transfusion medicine where specifically designed compounds perform the task of transport and delivery of oxygen in the body to replace this function of allogenic human blood transfusion. Several molecules have been developed in the past few decades to achieve this objective and continous refinements are being continuously made in the quest of the ideal blood substitute. Currently, available technology manufactures artificial blood from haemoglobin obtained from outdated human/bovine blood (Haemoglobin Based Oxygen Carriers) or utilizing Perfluorocarbons. These synthetic blood substitutes are advantageous in that they do not require compatibility testing, are free from blood borne infections, have prolonged shelf life and do not require refrigeration. Artificial blood is projected to have a significant impact on the development of medical care in the future. It can complement the current blood products for transfusion and create a stable supply of safe and effective products. It is likely to reduce the requirements of blood transfusions drastically especially in settings of trauma and surgery thereby reducing the reliance on banked donated blood.
Topics: Anemia; Animals; Blood Substitutes; Blood Transfusion; Fluorocarbons; Hemoglobins; Humans; Resuscitation
PubMed: 31204626
DOI: 10.2174/1871525717666190617120045 -
Surgery Jun 2000
Review
Topics: Animals; Blood Loss, Surgical; Blood Substitutes; Clinical Trials as Topic; Fluorocarbons; Hemoglobins; History, 19th Century; History, 20th Century; Humans; Hydrocarbons, Brominated; Raffinose
PubMed: 10840352
DOI: 10.1067/msy.2000.106462 -
Current Opinion in Anaesthesiology Aug 2007To discuss the development and current status of blood substitutes, including hemoglobin-based oxygen carriers (HBOCs) and perfluorocarbons. Research in this field... (Review)
Review
PURPOSE OF REVIEW
To discuss the development and current status of blood substitutes, including hemoglobin-based oxygen carriers (HBOCs) and perfluorocarbons. Research in this field offers an important view into the future of transfusion medicine in the operating room, as well as in trauma and combat arenas.
RECENT FINDINGS
A pivotal multinational phase III trial of the Biopure product HBOC-201 (Hemopure) has been completed in orthopedic surgery patients. HBOC-201 consists of polymerized bovine hemoglobin and has already been well tolerated in patients undergoing cardiopulmonary bypass and abdominal aortic reconstruction. Polyheme is a polymerized human hemoglobin in early phase III clinical trials with trauma patients, having infused up to 10,000 ml, with efficacy apparently demonstrated in phase II. The Sangart product, Hemospan, is currently undergoing phase II trials.
SUMMARY
Polymerized hemoglobin preparations have proven most successful in clinical trials due to their improved side-effect profile. The goal is to evaluate blood substitutes with enhanced intravascular retention, reduced osmotic activity, and attenuated hemodynamic derangements such as vasoconstriction. Although not without substantial morbidity and mortality, the current safety of allogeneic blood transfusion demands that comparative studies show minimal adverse effects, as well as efficacy and potential for novel applications.
Topics: Blood Substitutes; Fluorocarbons; Hemoglobins; Humans; Oxygen; Transfusion Reaction
PubMed: 17620840
DOI: 10.1097/ACO.0b013e328172225a -
Anesthesiology Nov 1999
Topics: Blood Substitutes; Colloids; Fluorocarbons; Humans; Oxygen
PubMed: 10551564
DOI: 10.1097/00000542-199911000-00005 -
Progress in Clinical and Biological... 1989
Review
Topics: Animals; Blood Substitutes; Humans; Military Medicine; United States
PubMed: 2695936
DOI: No ID Found