Усенко, Л.В. and Царев, А.В. (2018) Кровезаменители с газотранспортной функцией: надежды и реалии. Медицина неотложных состояний, № 1 (88). pp. 9-18. ISSN 2224-0586 (print), 2307-1230 (online)
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Abstract
Работа посвящена современному состоянию проблемы создания и клинического использования кровезаменителей с газотранспортной функцией. Описаны технологические направления разработок кровезаменителей с газотранспортной функцией. Осуществлен анализ проводимых исследований кровезаменителей на основе модифицированного гемоглобина, перфторуглеродов, а также использования молекулярных, клеточных и нанотехнологий. Приведен опыт широкого клинического применения кровезаменителя с газотранспортной функцией на основе перфторуглеродов. Продемонстрированы потенциальные преимущества использования кровезаменителей с газотранспортной функцией по сравнению с аллогенной кровью. The work deals with the current state of the problem of creation and clinical use of blood substitutes with gas transport function. Blood shortage is an important healthcare problem globally anticipated to become more problematic as people live longer and donor numbers reduces. So, there is a need for an alternative red cell product. The technological directions for the development of blood substitutes with gas transport function are described. The analysis of conducted researches of blood substitutes on the basis of modified hemoglobin, perfluorocarbons, as well as the use of molecular, cellular and nanotechnologies was carried out. The term “blood substitute” does not accurately describe the current candidate products because they typically have only two limited functions: carrying and delivering oxygen and augmenting blood volume. Although no single product can yet imitate all the properties of the blood, substantial progress has been made, especially in the development of hemoglobin based oxygen carriers. The perfluorocarbons are synthetic cyclic or linear hydrocarbons occasionally containing oxygen or nitrogen atoms, and the hydrogen atoms are replaced by fluorine atoms in them. They easily solubilize and release gases without interacting with them. The quantity of gas dissolved is linearly related to its partial pressure. The article presents the results of experimental study and clinical use (1984–2010) of perftorane in acute hemorrhage and hemorrhagic shock, traumatic brain injury, postresuscitation disease, acute myocardial infarction, septic shock, acute poisoning, fat embolism, as a component of cardioplegia under cardiosurgical interventions, vascular surgery and transplantology. Potential advantages of the use of blood substitutes with gas transport function as compared to allogeneic blood are demonstrated. The current state of the problem of creating and studying blood substitutes with gas transport function allows us to conclude that at present this group of drugs remains a potential that has not yet been realized, since they are not literally blood substitutes. Existing single drugs with gas transport function that have been used clinically cannot completely replace the blood function and do not allow to stop using donor red blood cells, but they allow you to gain precious time, making a decisive contribution to saving patients in critical conditions and to encourage further development of more modern blood substitutes. We are deeply convinced that these blood substitutes, which model the most important oxygen transfer function of the blood, will take a worthy place in the future among various methods that is an alternative to the use of donor blood.
| Item Type: | Article |
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| Uncontrolled Keywords: | кровезаменители; препараты модифицированного гемоглобина; перфторорганические соединения; перфторан; интенсивная терапия. blood substitutes; hemoglobin-based oxygen car- riers; perfluororganic compounds; perftorane; intensive care |
| Subjects: | Anesthesiology and Intensive care |
| Divisions: | Departments > Department of Anaesthesiology and Intensive Care |
| Depositing User: | Анастасия Жигар |
| Date Deposited: | 20 Sep 2018 13:04 |
| Last Modified: | 20 Sep 2018 13:04 |
| URI: | http://repo.dma.dp.ua/id/eprint/3205 |
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