1. Synthetic Oxygen Carriers Mohamed Dorgham Assisstent Lecturer in Anaesthesiology Depatement Ain-Shams University.

2. Red Blood Cell Substitute O2 Carriers Lack coagulation Immune function Nutrition Plasma protiens HB Solutions PFC

3. HB Tetramer Monomers Dimers 1. Filtered by the kidney 2.NO scavenger 3.Increase plasma osmotic pressure 4.High O2 affinity 1.Ultrastructural modification 2. Artificial Blood Cells HB Solutions

4. Cross linking Conjugantion Polymerization Microspheres Recombinent DNA Monomers and Dimers 1.Ultrastructural modification Tetramers Ultra purification

5. 2. Artificial Blood Cells Liposomes = Pseudoerythrocyte Nanocapsules Encapsulated Hb in cell like structure Coated with Phospholipid Bilayer and Cholesterol Coated with Polylactide

6. Adverse Effects Of Hb Solutions Immunsuppression Decreased phagocytic activity Nephrotoxicity RBC membrane Coagulopathy RBC membrane Free radicals Artificial RBC Vasoconstriction NO inactivation Endothelins Neurotoxicity NO inactivation Lab Interference

7. PFC Synthetic organic liquid compounds 8-10 carbon atoms H+ atomsHalogens Flourine BromineIodine !st Generation Fluosol 20% Stored Frozen Limited O2 carrying capacity.Allergic reaction !st Generation Fluosol 20% Stored Frozen Limited O2 carrying capacity.Allergic reaction 2 nd Generation Oxygent 90% Stored at 4’c High O2 Carrynig capacity 2 nd Generation Oxygent 90% Stored at 4’c High O2 Carrynig capacity

8. 1.Higher O2 Solubility Coefficient. 2.V. low viscosity 3.High Density 4.High N2 Solubility 5.Inactivate NO Resuscitation Preop Blood donation Periop hemodilution Organ preservation Sickle crisis Vascular diseases Synthetic vessels (CPB,ECMO, HD) Alveolar recruitment Liquid ventilation Decompression sickness Septic shock

9. Adverse Effects Of PFC Allergy Especially 1 st Gen Bleeding Tendency Decrease Plt Count Increase Liver Enzymes Acute Rt sided Failure Pulmonary Plt microemboli Pulmonary Hage Pulmonary edema Early: Headache Late: Flu like symptoms

10. Thank You