The Preoperative Treatment of Severely Anemic Patients with a Perfluorochemical Oxygen-Transport Fluid, Fluosol-DA

Abstract

We gave a perfluorochemical oxygen-transport fluid and plasma expander, Fluosol-DA, to seven severely anemic patients before surgery to determine its effectiveness in supplementing oxygen transport. The dose of Fluosol in the five patients completing the study was 20 ml per kilogram of body weight. When the patients breathed low levels of supplemental oxygen (mean partial pressure of arterial oxygen ±S.D., 101 ±25 torr), the perfluorochemical carried a small amount of oxygen, but when they received pure oxygen (arterial oxygen pressure, 361 ±65 torr) it carried approximately 0.8 per cent of oxygen (by volume). This increase accounted for 7±3 per cent of the patients' arterial oxygen content and 24 ±7 per cent of their oxygen consumption. The cardiac index and left ventricular stroke-work index decreased, whereas the oxygen delivery increased, although these changes were not statistically significant. Significant changes included a 22 per cent increase in oxygen consumption, a 59 per cent increase in mixed venous oxygen tension, and an increase in mixed venous hemoglobin saturation to 90±6 per cent. We conclude that at ambient oxygen tensions Fluosol acts primarily as a volume expander, whereas at higher tensions (>300 torr) it contributes substantially to the oxygen delivery system. (N Engl J Med. 1982; 307:277–83.)