Blood substitutes history

Scientific research today sometimes produces strange bedfellows, teams of scholars from fields that might seem very far apart and distinct from each other. Research on biomaterials is one area with many such examples. Someone interested in developing an artificial heart, a blood substitute, or a new material that can be used for bone must know a little something about many topics from biology, chemistry, and physics. Even better, such research can be carried out most efficiently when scholars from each of these fields is involved in a research program. One of the best examples of that point is found in the history of research on artificial skin, in which loannis V. Yannas made an important breakthrough. 

Chen J, Scerbo M, Kramer G. Review of blood substitutes examining the history, clinical trail results and ethics of hemoglobin-based oxygen carriers. Chnics 2009 64 803-13. 

The history of fluorochemical blood substitutes started with the dramatic demonstration that a mouse can stay alive while submerged in a fluorochemical saturated with oxygen [163]. Since the early days of great optimism, the limitations of fluorochemical emulsions as blood substitutes have been recognized [5]. Difficulties with the preparation of stable emulsions, a low oxygen content at atmospheric pressures, and in vivo accumulation of fluorochemicals in tissues have restricted their intravascular use as blood substitutes [38]. The main emphasis is now on diagnostic applications and oxygen transport into ischemic tissues. 

A 50-yea.r-old male with a two-year history of essential hypertension well controlled on hydrochlorothiazide is found on a recent physical examination to have a blood pressure of 160/105 mmHg. The hydrochlorothiazide is substituted with another agent. Two weeks later, he returns for follow-up complaining of a loss of taste. 

Albumin (human) Epoetin alfa contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. No cases of transmission of viral diseases or Creutzfeldt-Jakob disease have ever been identified for albumin. Anemia Not intended for CRF patients who require correction of severe anemia epoetin alfa may obviate the need for maintenance transfusions but is not a substitute for emergency transfusion. Not indicated for treatment of anemia in HIV-infected patients or cancer patients due to other factors such as iron or folate deficiencies, hemolysis, or Gl bleeding, which should be managed appropriately. Hypertension Up to 80% of patients with CRF have a history of hypertension. Do not treat patients with uncontrolled hypertension monitor blood pressure adequately before initiation of therapy. Hypertensive encephalopathy and seizures have occurred in patients with CRF treated with epoetin. 

The mechanisms by which thiazides affect erectile dysfunction or libido are unclear, but it has been suggested that they have a direct effect on vascular smooth muscle cells or reduce the response to catecholamines. Sexual dysfunction does not appear to be mediated by either a low serum potassium concentration or a low blood pressure. Since sexual dysfunction can adversely affect the quality of life of hypertensive patients, physicians or health-care providers should take an accurate baseline sexual history and monitor sexual status for changes during therapy. If there are significant changes in sexual function, diuretic therapy can be withdrawn and an alternative drug class substituted. However, not uncommonly sexual dysfunction will persist despite withdrawal of the diuretic, suggesting that elements of the hj pertensive state itself contribute to the process. 

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