Perfluorocarbons as blood substitutes: the early years. Experience with Fluosol DA-20% in the 1980s.
Clinical testing of perfluorocarbons (PFC) as blood substitutes began in the early 1980's in the form of Fluosol DA-20% (FDA), a mixture of perfluorodecalin and perfluorotripropylamine emulsified with Pluronic F68. We have treated 55 patients (Treatment (T) = 40; Control (C) = 15) with intravenous infusions of 30 cc/kg of FDA as part of either a randomized, clinical trial or a humanitarian protocol. All patients were Jehovah's Witnesses who refused blood transfusion and were severely anemic (mean hemoglobin = 4.6 g/d). FDA successfully increased dissolved or plasma oxygen content (P1O2 in ml/dl), but not overall oxygen content (T group: P1O2 baseline = 1.01 +/- .27, P1O2 12hrs = 1.58 +/- .47 [p = < .0001, t-test]; P1O2 12 hrs: T = 1.58 +/- .47, C = 1.00 +/- .31, p = < .0002, t-test). This effect persisted for only 12 hours post infusion, and had no apparent effect on survival. FDA is an ineffective blood substitute because of low concentration and short half-life. Improved emulsion design may resolve these problems, thereby producing a more effective agent. Our discussion will include a review of our data plus a summary of other reports of FDA efficacy as a blood substitute.
Spence
R K
RK
Medical University of South Carolina, Charlestown 29425-2270.
Norcross
E D
ED
Costabile
J
J
McCoy
S
S
Cernaianu
A C
AC
Alexander
J B
JB
Pello
M J
MJ
Atabek
U
U
Camishion
R C
RC
D000740:Anemia / Q000628:therapy*; D001802:Blood Substitutes / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D005466:Fluorocarbons / Q000627:therapeutic use*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives; D016032:Randomized Controlled Trials as Topic
D001802:Blood Substitutes; D004338:Drug Combinations; D005466:Fluorocarbons; D006895:Hydroxyethyl Starch Derivatives; C017323:glucose, glycerol, hydroxyethyl starch, perfluorodecalin, perfluorotripropylamine, pluronic F-68, salts, yolk phospholipids drug combination