The Annals of Thoracic Surgery, Vol 32, 528-535, Copyright © 1981 by The Society of Thoracic Surgeons
Fluosol-DA: an artificial blood for total cardiopulmonary bypass
RM Engelman, JH Rousou and WA Dobbs
The isolated, in situ pig heart model was used to determine if Fluosol
could support myocardial function during cardiopulmonary bypass. Fourteen
pigs were utilized; 7 underwent studies of myocardial metabolism (coronary
blood flow and vascular resistance, myocardial oxygen consumption and
extraction, lactate extraction, and adenosine triphosphate and creatine
phosphate levels), and 7 underwent studies of myocardial contractility and
compliance (intraventricular balloon measurements). Each study was carried
out utilizing one hour of control hemic perfusion, followed by one hour of
Fluosol perfusion, and followed by a third hour of a return of hemic
perfusion. The results documented that in the vented, beating, nonischemic
heart, myocardial metabolism and functional measurements are maintained
during an hour of Fluosol perfusion. However, because of an increased level
of ionized calcium during Fluosol perfusion, myocardial functional
measurements document significantly increased contractility. The increased
contractility is associated with an increase in anaerobic metabolism. The
latter contributes to a decline in the high-energy phosphate level
following a return of hemic perfusion as the heart recovers from the
increased work load placed on it during Fluosol perfusion. It is concluded
that here is sufficient oxygen-carrying capacity in Fluosol- DA to maintain
cardiac function during perfusion in the large animal model. However, the
carrier solution for the Fluosol must be adjusted to appropriate
electrolyte content to avoid adverse effects on the myocardium.
