6533b82ffe1ef96bd1295045
RESEARCH PRODUCT
Oxygen-carrying v. non-oxygen-carrying colloidal blood substitutes in schock
A. MadjidiW. ErdmannH. BeisbarthLate R. Freysubject
FluorocarbonsBlood transfusionbusiness.industrymedicine.medical_treatmentPlasma SubstitutesOxygen transportBlood volumeShock HemorrhagicOxygen-carryingVolume (thermodynamics)Blood lossBlood SubstitutesAnesthesiaAnimalsHumansGeneral Earth and Planetary SciencesMedicinebusinessRespiratory minute volumeGeneral Environmental ScienceWhole blooddescription
Loss of more than 10-15 per cent of the circulating blood causes a corresponding fall in filling pressure and a marked reduction in minute volume. In order to combat a fall in the minute volume, catecholamines are liberated, the stimulating components of these cause a rise in vessel tone. In spite of the blood volume being reduced by blood loss, filling pressure and minute volume are restored by compensating mechanisms as long as the volume lost is not enough to exceed the autoregulative capacity. Even with a blood loss of 10-15 per cent, full compensation is not achieved without replenishing the blood volume unless the fluid lost from the vascular bed is less than I0 per cent of the total. Haemoglobin is also lost with the blood, and it is reasonable to replenish the intravascular fluid level with whole blood and therefore not only restore the minute volume but also the oxygen transport capacity. However, good blood reserves for transfusion will always be limited because: a, the number of donors is limited, and they cannot give blood all the time; b. blood only keeps for 3 weeks; c. whole blood can only be stored in local banks and transported at fairly high costs at a temperature of 4-6 °C, with critical shortages in the event of a disaster with mass casualties. Furthermore, the incidence of infection transmitted by donor blood has not been abolished, and respect for the religious conviction of patients rejecting transfusion of blood or blood derivatives presents a moral and ethical dilemma to the majority of doctors. Thus, the ambition to escape from dependence on blood and blood derivatives is not new and really continues as long as blood transfusion is performed.
year | journal | country | edition | language |
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1982-07-01 | Injury |