Mini review on Artificial Blood Substitutes: Future perspective of Perfluorocarbon based oxygen carriers

Abstract

The primary cause of death in the battle field and in civilian trauma is haemorrhagic shock. Around 50% combat deaths occur due to haemorrhage, depending on the severity of bleeding medical supervision can be provided like in catastrophic haemorrhage individual death occurs before providing the medical care and it is not a prehospital combat medical management problem during warfare scenario, even to transport wounded personnel to causality centre often takes 45 minutes to one hours. The hazardous nature of the forward combat areas and hostile operational environment frequently prevents medical personnel from quickly reaching the wounded even if the transport distances are small. Moreover, injuries with penetrating battlefield trauma often have only a "platinum 5 minutes." It is very important for military medical personnel to understand their options for treating haemorrhage quickly and efficiently during combat. Early intervention and definitive treatment could save up to 30% of soldier’s who die of action or of wounds. In view of this there is a requirement for the development of synthetic blood substitutes or oxygen therapeutic agents (OTA) in order to maintain the tissue oxygenation. Blood substitutes are the substances which mimic one of the physiological functions of the blood that is transportation of oxygen and carbon dioxide throughout the body. Blood substitutes or OTAs are being clinically tested as artificial oxygen carriers to improve tissue oxygenation and also to reduce allogenic blood transfusions. Two types of blood substitutes are reported so far: 1. Haemoglobin based oxygen carriers (HBOCs) and 2. Perfluorocarbon based oxygen carriers (PFOCs). PFOCs has huge advantages like universal compatibility, no requirement of cold storage, longer shelf life and no risk of infection transmission. These products have their own limitations and they have been withdrawn from international market for clinical use because of their side effects. It is a challenging task to the scientists to develop a safe, stable and biocompatible blood substitute for combat scenarios and also for civilian applications.