Blood Substitutes

plasma substitutes, agents used for therapeutic purposes instead of blood transfusion, for the dilution of banked whole blood, and in cases of shock, blood loss, burn, anemias, and purulent septic diseases.

The injection of blood substitutes is often combined with the transfusion of donor blood. Blood substitutes are divided, according to action, into antishock, detoxification, and parenteral-feeding preparations. Many blood substitutes have compound effects.

The most commonly used antishock preparations are polyglucin (dextran), polyvinylpyrrolidone, and gelatin preparations. Polyglucin is a polymer of glucose that is synthesized by the bacteria Leuconostoc mesenteroides. Soviet polyglucin does not decrease the function of the coagulation system. Polyvinylpyrrolidone is a polymer that consists of 250 to 300 chains of vinylpyrrolidone. Gelatinol, which is produced from modified gelatin, is used in extracorporeal blood circulation (in heart operations).

Detoxification blood substitutes are represented by preparations of low-molecular-weight polyvinylpyrrolidone (molecular weight, 10,000–12,000). The preparations (in particular, Gemodez) contain 6-percent low-molecular-weight polyvinylpyrrolidone and saline or glucose solutions. They are highly effective in detoxification with radiation sickness and burn diseases. Low-molecular-weight polyvinylpyrrolidone has a diuretic effect and reduces stasis in the capillaries. Protein preparations also have a detoxifying effect.

The preparations used in parenteral feeding include native protein products (plasma and albumin) and protein hydrolysates (casein hydrolysate of the Central Order of Lenin Scientific Research Institute of Hematology and Blood Transfusion, hydroly-sate L-103, and aminopeptide). These are used to treat weakened postoperative patients, burns of the esophagus, hypoproteinemic states of various etiology, and burn diseases.

Fatty emulsions (from 10 to 20 percent fat) from cottonseed oil (Lipofundinum in the Federal Republic of Germany; Lipomulum in the USA) and soybean oil (Intralipidum in Sweden) are also manufactured as parenteral substitutes. Lipomaiz, made from corn oil at the Leningrad Blood Transfusion Institute, contains 10 percent fat. These emulsions are used parenterally to increase the body’s energy resources. The combined use of hydrolysates and fat emulsions is recommended.