The
oxygen carried inside plasma performs differently than the
oxygen carried inside red cells. Only 0.13-0.3 mL of
oxygen in 100 mL of blood is available inside plasma while 14-19 mL of
oxygen is carried inside red cells. Thus, less than 5-8 mL of
oxygen is available in the plasma of the entire body. When a patient develops
hypovolemic shock, red cells are bypassed and are not perfused directly inside the tissues. However, plasma should reach such hypoxic tissues. Thus, an infusion of
oxygen-carrying macromolecules in plasma with a
hemoglobin concentration of only 6% and P50 value of 24 mm Hg should be therapeutically effective even if less than 100 mL of stabilized
hemoglobin solution (conjugated
hemoglobin of 90,000 Da with a molecular size of less than 10 nm or 0.01 microm) are infused under
shock conditions. The basic physiology of
oxygen-carrying macromolecules is described in detail, which is different from the
oxygen carried inside the red cells and inside encapsulated
oxygen-carrying particles (typically 250 nm or 0.25 microm). Thus, the
oxygen-carrying macromolecues are extremely effective in the treatment of
shock patients. In emergency cases, after the
bleeding is controlled, a small infusion volume of
oxygen-carrying macromolecules will supply sufficient
oxygen to the hypoxic tissues and immediately improve the blood pressure of
shock patients.