Synthetic Oxygen Carriers

Mohamed DorghamAssisstent Lecturer in

Anaesthesiology Depatement Ain-Shams University.

Red Blood Cell Substitute

O2 Carriers

Lack coagulation

Immune functionNutrition

Plasma protiens

HB Solutions PFC

HBTetramer

Monomers Dimers

1. Filtered by the kidney2.NO scavenger3.Increase plasma osmotic

pressure4.High O2 affinity

1. Ultrastructural modification1. Ultrastructural modification

2. Artificial Blood Cells2. Artificial Blood Cells

HB Solutions

Cross linking

Conjugantion

Polymerization

Microspheres

Recombinent DNA

Monomers and Dimers

1. Ultrastructural modification1. Ultrastructural modification

Tetramers

Ultra purification

2. Artificial Blood Cells2. Artificial Blood Cells

Liposomes=

Pseudoerythrocyte

Nanocapsules

Encapsulated Hb in cell like structure

Coated withPhospholipid Bilayer and Cholesterol

Coated withPolylactide

Adverse Effects

Of Hb Solutions

Adverse Effects

Of Hb Solutions

ImmunsuppressionDecreased

phagocytic activity

NephrotoxicityRBC membrane

CoagulopathyRBC membrane

Free radicalsArtificial RBC

VasoconstrictionNO inactivation

Endothelins

NeurotoxicityNO inactivation

Lab Interference

PFC

Synthetic organic liquid compounds

8-10 carbon atomsH+ atoms Halogens

Flourine Bromine

Iodine !st GenerationFluosol 20%• Stored Frozen• Limited O2 carrying capacity.Allergic reaction

!st GenerationFluosol 20%• Stored Frozen• Limited O2 carrying capacity.Allergic reaction

2nd GenerationOxygent 90%• Stored at 4’c•High O2 Carrynig capacity

2nd GenerationOxygent 90%• Stored at 4’c•High O2 Carrynig capacity

1. Higher O2 Solubility Coefficient.

2. V. low viscosity

3. High Density

4. High N2 Solubility5. Inactivate NO

• Resuscitation•Preop Blood donation•Periop hemodilution•Organ preservation

•Sickle crisis•Vascular diseases•Synthetic vessels (CPB,ECMO, HD)•Alveolar recruitment•Liquid ventilation•Decompression sickness•Septic shock

Adverse Effects

Of PFC

Adverse Effects

Of PFC

AllergyEspecially 1st Gen

Bleeding TendencyDecrease Plt Count

Increase Liver

Enzymes

•Acute Rt sided Failure Pulmonary Plt microemboli•Pulmonary Hage•Pulmonary edema

•Early: Headache

•Late: Flu like symptoms

Thank You