What are oxygen-carrying blood substitutes?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Oxygen-carrying blood substitutes are divided into 2 types: (1) fluorocarbon-based synthetic oxygen carriers, and (2) stroma-free, cross-linked, or polymerized human or nonhuman hemoglobin preparations. These compounds may be useful in acute massive blood loss, such as trauma and major operations, and have also been used in patients declining transfusion for religious reasons.

The fluorocarbon-based oxygen carriers are easily produced, have a long shelf life, and have minimal infectious or immunologic complications. However, they require a high FiO2 and are cleared rapidly.

The hemoglobin-based oxygen carriers have a high oxygen-carrying capacity, significant oncotic effect, and a long shelf life. However, they are also rapidly cleared and may induce systemic and pulmonary hypertension through vasoactivity.

Although successes with the use of oxygen-carrying blood substitutes have been reported in small studies and anecdotal case reports, [72, 73, 74] ongoing efforts with respect to further clinical development have been disappointing and plagued with safety concerns. [61, 75, 76]

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