Perfluorocarbon as Blood Substitute in Clinical Applications and in War Casualties

Abstract

The results of infusion of fluorocarbon blood substitute (FCBS) in surgical patients (including war casualties) are presented. One hundred and forty patients (male 82, female 58, age 17–71 years) were infused with 200–1,000 ml of FCBS during operation. Fourteen cases were emergency operations because of trauma and/or hemorrhagic shock and 113 cases were selective operations. Thirteen cases were war casualties. Seventy-three patients also received 300–2,700 ml of banked blood.

The vital signs and ECG received normal and blood pressure increased significantly (compared to pre-infusion P 0.01) during and after infusion. Hemoglobin and RBC values did not change significantly, however, WBC counts increased for a week. PaO₂ increased significantly (P < 0.05) compared with preinfusion or the control group (infused with same dose of HES). pH and PaCO₂ did not change remarkably. Platelet count decreased transiently, but platelet function did not change, nor did coagulation function. Fibrinolysis was more active, but recovered in 24 hours. The decrease of CH₅₀ was observed immediately after infusion and recovered in 72 hours. There was no change in hepatic and renal function; however, transient increase of SGPT was found in 3 cases.

The results suggested that the FCBS had the capacity of carrying oxygen and expanding plasma volume. It is efficient to apply as an alternative to blood transfusion during operation in treatment of traumatic and/or hemorrhagic shock even in war casualties.

Transient chest tightness and/or flushing were found in 5 cases at the beginning of the infusion, and disappeared when the infusion slowed down. Urticaria after infusion were observed in 2 cases. The mechanism of side effects is still being investigated.

Perfluorocarbon blood substitute (FCBS) is a superfine emulsion comprised of perfluorochemicals capable of carrying oxygen, and of expanding blood volume, and has been applied clinically. (1,2) This article reports the results of clinical studies using FCBS in 140 cases in our institute from August. 1982 to June, 1986.