Surgical Use of Fluosol‐DA in Jehovah's Witness Patients

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Abstract
The effects of Fluosol‐DA 20% on circulating blood cells, hemodynamic parameters, blood gases, and organs are described and compared with the results of phase I human studies and animal experiments. Because of preoperative anemia and/or surgical bleeding, Fluosol‐DA 20% was administered to 7 of 10 Jehovah's Witness patients treated in this hospital. Six received 1,000 ml and the seventh received 2,000 ml. Hematological changes were examined after the administration of a 1‐ml test dose and at early and late stages of Fluosol‐DA 20% administration. Hemodynamics and blood gases were measured before and after infusion of Fluosol‐DA 20%. Hepatic function was also determined. A drop in neutrophils and platelets was observed in some patients after the injection of a 1‐ml test dose. This transient reaction was of short term, and the neutrophil and platelet levels recovered spontaneously. Both the efficacy and the safety of Fluosol‐DA 20% were demonstrated in these patients. Summary: Because of preoperative anemia and/or moderate surgical bleeding, Fluosol‐DA 20% was administered to seven Jehovah's Witness patients: six with a dose of 1,000 ml each and one with a dose of 2,000 ml. A transient drop in neutrophils and platelets was observed in four patients after the injection of a 1‐ml test dose of Fluosol‐DA 20%. However, pretreatment with drugs seemed to be dispensable because this initial reaction was transient and reversible. The efficacy and safety of Fluosol‐DA were demonstrated in these patients when the fractional concentration of the oxygen in inspired gas was ˜0.5 or 0.6. Intravenous administration of Fluosol‐DA 20% (up to 30 ml/kg) to hemorrhagic patients supported the hypothesis that Fluosol‐DA 20% can be used clinically as a blood gas carrier, in emergency situations, without any untoward reactions.