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Fluorocarbons and the microcirculation.

A short discussion of oxygen transport and delivery by fluorocarbon containing blood substitutes is presented. Those physical properties of the preparations that would tend to cause improvement in oxygenation in areas of damaged or impeded microcirculation are also discussed. A number of studies carried out at the Erasmus University, Rotterdam have demonstrated certain important characteristics of fluorocarbons with respect to tissue oxygenation. In the first instance, it has been demonstrated that extracorporal perfusion with Fluosol-DA 20% can maintain oxygenation and viability of isolated extremities for periods of up to 48 hours. Secondly it has been shown that the preparation can indeed penetrate compromised capillary beds, its low viscosity enabling it to travel along collateral perfusion pathways and to provide oxygenation of areas of ischaemic hypoxia. The low particle of the emulsion may, in combination with the low viscosity of the product, contribute to the re-establishment of perfusion in areas of circulatory arrest. The clinical implications of the above findings are numerous and wide spread. The importance of Fluosol in maintaining and improving micro-circulatory oxygenation should not be underestimated.