We assessed the safety and efficacy of
Fluosol-DA as a
red-cell substitute in acute
anemia. Twenty-three surgical patients with blood loss and religious objections to receiving
blood transfusions were evaluated. Fifteen moderately anemic patients with a mean
hemoglobin level (+/- SE) of 7.2 +/- 0.5 g per deciliter had no evidence of a physiologic need for increased arterial
oxygen content and did not receive
Fluosol-DA. Eight severely anemic patients with a mean
hemoglobin level of 3.0 +/- 0.4 g per deciliter met the criteria of need and received the
drug until the physiologic need disappeared or a maximal dose of 40 ml per kilogram of
body weight was reached. We observed no adverse reactions to
Fluosol-DA. The average peak increment in arterial
oxygen content with the
drug was only 0.7 +/- 0.1 ml per deciliter. There were no appreciable beneficial effects of
Fluosol-DA, perhaps because of the small increase in arterial
oxygen content, the brief half-life of the
drug (24.3 +/- 4.3 hours), and the limited total dose. Six of the eight patients receiving
Fluosol-DA died. One of the survivors received red-cell transfusions against his wishes, under a court order, after his total
Fluosol-DA dose. Fourteen of the 15 moderately anemic patients survived. The data in this select group of patients refusing blood products suggest that, after blood loss,
Fluosol-DA is unnecessary in moderate
anemia and ineffective in severe
anemia.