Fluosol-DA as a red-cell substitute in acute anemia.
We assessed the safety and efficacy of Fluosol-DA as a red-cell substitute in acute anemia. Twenty-three surgical patients with blood loss and religious objections to receiving blood transfusions were evaluated. Fifteen moderately anemic patients with a mean hemoglobin level (+/- SE) of 7.2 +/- 0.5 g per deciliter had no evidence of a physiologic need for increased arterial oxygen content and did not receive Fluosol-DA. Eight severely anemic patients with a mean hemoglobin level of 3.0 +/- 0.4 g per deciliter met the criteria of need and received the drug until the physiologic need disappeared or a maximal dose of 40 ml per kilogram of body weight was reached. We observed no adverse reactions to Fluosol-DA. The average peak increment in arterial oxygen content with the drug was only 0.7 +/- 0.1 ml per deciliter. There were no appreciable beneficial effects of Fluosol-DA, perhaps because of the small increase in arterial oxygen content, the brief half-life of the drug (24.3 +/- 4.3 hours), and the limited total dose. Six of the eight patients receiving Fluosol-DA died. One of the survivors received red-cell transfusions against his wishes, under a court order, after his total Fluosol-DA dose. Fourteen of the 15 moderately anemic patients survived. The data in this select group of patients refusing blood products suggest that, after blood loss, Fluosol-DA is unnecessary in moderate anemia and ineffective in severe anemia.
Gould
S A
SA
Rosen
A L
AL
Sehgal
L R
LR
Sehgal
H L
HL
Langdale
L A
LA
Krause
L M
LM
Rice
C L
CL
Chamberlin
W H
WH
Moss
G S
GS
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000747:Anemia, Hypochromic / Q000188:drug therapy*; D001802:Blood Substitutes / Q000627:therapeutic use*; D004338:Drug Combinations / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D004341:Drug Evaluation; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006207:Half-Life; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000188:drug therapy
D001802:Blood Substitutes; D004338:Drug Combinations; D005466:Fluorocarbons; D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; C017323:glucose, glycerol, hydroxyethyl starch, perfluorodecalin, perfluorotripropylamine, pluronic F-68, salts, yolk phospholipids drug combination; D010100:Oxygen