A substitute for blood is a long-sought goal: after William Harvey described the circulation of the blood in 1628, Christopher Wren experimented with various solutions, including wine, and other substances, without success. Efforts were suspended when death resulted from transfusion of blood itself, until replacement of blood with milk was attempted in an outbreak of cholera in the late 19th century. The words of John Brinton (1878) predate in almost startling fashion, some of the claims that have been made by “blood substitute” developers in recent years: “this new operation will, in a few years, have entirely superseded the transfusion of blood, which latter operation is even now being rejected as at once dangerous and unavailing in may parts of the country.”
Despite intense research and 128 years, development of an oxygen-carrying plasma expander remains a prized goal in both academia and industry. Many different solutions have been developed and tested to varying degrees in animals and in humans. Some are based on perfluorocarbon emulsions, acting simply to increase the amount of non-hemoglobin bound oxygen. Others are based on hemoglobin, modified in various ways to reduce the toxic effects of hemoglobin and to try to duplicate the oxygen transport properties of red blood cells. Still other products are based on encapsulation of hemoglobin in lipid vesicles. For further information on all types of blood substitute products, the reader is referred to a recent comprehensive review of the entire field (
Blood Substitutes, Elsevier, 2006).
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