Blood substitutes for surgery and trauma: efficacy and toxicity issues.
Solutions of modified haemoglobin and perfluorocarbon emulsions are currently being tested in advanced human trials. Concerns about renal injury and hypertension with the haemoglobin solutions, and drug retention and pulmonary injury with the perfluorocarbons have been successfully addressed. However, newly recognised inflammatory toxicities of the haemoglobin solutions and the low oxygen-carrying capacity of the perfluorocarbons remain as potential limits on efficacy. As a result, the role of blood substitutes will be less than originally imagined, and none is likely to be licensed for use for several years.
Hess
J R
JR
Blood Research Detachment, Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA. john.hess@amedd.army.mil