Clinical Needs for Artificial Oxygen Carriers in Anaesthesia

Summary

Transfusion of blood is associated with high costs in the anaesthesia department. Immunological testing and/or cross-matching is routinely done before many operations entailing only a small risk of major haemorrhage. The introduction of artificial oxygen substitutes would save not only the cost of the erythrocytes but also of the extensive blood testing. In operations with an expected large blood loss, competition with donated blood will probably be focused largely on the potential prevention of adverse effects and infection. In the intensive care unit, a beneficial influence on blood rheology is more important than during surgery, and it must be possible to evaluate oxygen delivery after administration of the artificial oxygen substitute. For trauma outside hospital, artificial oxygen substitutes compete with fluid resuscitation as donated blood is rarely an option. Surprisingly, it is currently unclear where and when fluid resuscitation should be provided in the prehospital setting. Long transport times and head trauma are currently the most apparent indications. Artificial oxygen substitutes should be available at short notice, i.e., not requiring thawing, in order to be successful products. Here, volume expansion is a desired property along with improvement in oxygen-carrying capacity.