Transcript Synthetic oxygen carriers
Synthetic Oxygen Carriers
Mohamed Dorgham Assisstent Lecturer in Anaesthesiology Depatement Ain-Shams University.
Red Blood Cell Substitute O2 Carriers
Lack coagulation Immune function Nutrition Plasma protiens
HB Solutions
PFC
HB Solutions
HB Tetramer Monomers 1. Filtered by the kidney 2. NO scavenger 3. Increase plasma osmotic pressure 4. High O2 affinity
1. Ultrastructural modification
Dimers
2. Artificial Blood Cells
1. Ultrastructural modification Monomers and Dimers Cross linking Conjugantion Polymerization Microspheres Ultra purification Recombinent DNA Tetramers
2. Artificial Blood Cells
Encapsulated Hb in cell like structure
Liposomes = Pseudoerythrocyte Nanocapsules
Coated with
Phospholipid Bilayer
and
Cholesterol
Coated with
Polylactide
Immunsuppression
Decreased phagocytic activity
Coagulopathy
RBC membrane
Free radicals
Artificial RBC
Neurotoxicity
NO inactivation
Adverse Effects Of Hb Solutions Nephrotoxicity
RBC membrane
Vasoconstriction
NO inactivation Endothelins
Lab Interference
PFC Synthetic organic liquid compounds 8-10 carbon atoms
H+ atoms Halogens Flourine Bromine Iodine
!st Generation
Fluosol 20%
• Stored Frozen • Limited O2 carrying capacity.
Allergic reaction
2 nd Generation
Oxygent 90%
• Stored at 4’c • High O2 Carrynig capacity
1.
Higher O2 Solubility Coefficient.
2.
3.
4.
5.
V. low viscosity High Density High N2 Solubility Inactivate NO
•
Resuscitation
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Preop Blood donation
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Periop hemodilution
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Organ preservation
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Sickle crisis
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Vascular diseases
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Synthetic vessels (CPB,ECMO, HD)
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Alveolar recruitment
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Liquid ventilation
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Decompression sickness
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Septic shock
Allergy
Especially 1 st Gen
Increase Liver Enzymes
Adverse Effects Of PFC
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Acute Rt sided Failure
Pulmonary Plt microemboli •
Pulmonary Hage
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Pulmonary edema Bleeding Tendency
Decrease Plt Count •
Early: Headache
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Late: Flu like symptoms