Blood substitutes are solutions designed for use in patients who need blood transfusions, but for whom whole blood is not available, or is not safe. This interest has intensified in the wake of the AIDS and hepatitis C epidemics. Blood Substitutes describes the rationale, current approaches, clinical efficacy, and design issues for all blood substitutes now in clinical trials. The many summary diagrams and tables help make the book accessible to readers such as surgeons and blood bankers, who have less technical expertise than the biochemists and hematologists who are designing and testing blood substitutes.

Key Features

* Includes chapters necessary to the understanding of blood substitutes, including history, toxicity, physiology, and clinical applications * Presents detailed descriptions of the various products that have been developed and have advanced to clinical trials, and some that are in earlier states of development


Hematologists, blood bankers, biochemists, and biotechnologists working in the hemoglobin area, as well as surgeons working with blood

Table of Contents

BACKGROUND Historical Background Transfusion Medicine Regulatory Perspectives on Clinical Trials for Oxygen Therapeutics in Trauma and Transfusion Practice PHYSIOLOGICAL BASIS Clinical Physiology: Oxygen Transport and the Transfusion Trigger The Role of Oxygen and Hemoglobin Diffusion in Oxygen Transport by Cell-Free Hemoglobins Oxygen Transport Properties of Hemoglobin- Based Oxygen Carriers: Studies Using Artificial Capillaries and Mathematical Stimulation Mechanisms of O2 Transport in the Microcirculation: Effects of Cell-Free O2 Carriers Shear Stress, Mechanotransduction and the Flow Properties of Blood Local Regulation of Blood Flow CLINICAL APPLICATIONS Clinical Indications for Blood Substitutes and Optimal Properties Crystalloid Solutions Hemoglobin-Based Oxygen Carriers as Resuscitative Solutions for Trauma and Combat Casualty Care Surgical Hemorrhage Clinical Trials in Cardiac Surgery Hemodilution Clinical Hemodilution Potential for Blood Substitutes in Tissue Ischemia TOXICITY AND SIDE EFFECTS Redox and Radical Reactions of Hemoglobin Solutions: Toxicities and Protective Strategies Pro-oxidant Activity of Hemoglobin and Endothelial Cytotoxicity Renal Toxicity Hemoglobin and Neurotoxicity The Role of Inflammation in the Toxicity of Hemoglobin-based Oxygen Carriers Hemoglobin-Induced Myocardial Lesions PERFLUOROCARBON-BASED OXYGEN CARRIERS Fluorocarbon Emulsions As In Vivo Oxygen Delivery Systems: Background And Chemistry Fluosol: The First Commercial Injectable Perfluorocarbon Oxygen Carrier


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© 2005
Academic Press
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About the author

Robert Winslow

Professor Winslow received his M.D. degree and postgraduate training in internal medicine and hematology at the Johns Hopkins University and Hospital. He studied hemoglobin biochemistry at the Massachusetts Institute of Technology and Molecular Biology at the National Institutes of Health. His research, for more than 30 years, has been aimed at the intersection of the synthesis, structure and function of hemoglobin, in such areas as sickle cell anemia, high altitude physiology and hemoglobin-based oxygen carriers. Professor Winslow previously headed the Blood Research Division at the Letterman Army Institute of Research, responsible for the US Army's blood substitute program. Between 1991 and 1998, he was a Professor of Medicine, leading a blood substitute program at the University of California at San Diego (UCSD), supported by the National Institutes of Health. Professor Winslow has also served as a consultant to many private companies and has been an advisor for, among others, the Federal Aviation Administration (FAA), Food and Drug Administration (FDA), the Institute of Medicine of the National Academy of Science, the Pan American Health Organization, the National Institutes of Health, the Department of Defense and a number of foreign governments. He has written more than 200 scientific articles on clinical, physiological and biochemical aspects of hemoglobin and oxygen transport.

Affiliations and Expertise

University of California, Department of Medicine and Veterans Affairs Medical Center, San Diego, U.S.A.


"Robert Winslow's new book Blood Substitutes, is useful in many ways. It brings together well-written summaries of the work of many of the most important investigators of the last 2 decades in the broad group of interrelated fields. Moreover, it also has some excellent chapters of scientific and medical background that provide context for the work. It also gives a historical snapshot of the thinking and attitudes of workers in the field. As an introduction to the field, this book is outstanding." - John R. Hess MD, MPH, FACPa, University of Maryland Medical Center for TRANSFUSION MEDICINE REVIEWS (2006) "There aren't too many all in one books on this subject, let alone one written this clearly, concisely, and with perspective. If you are interested in this field, get this book." - Doody's 3 Star Review by Valerie L. Ng, PhD, MD, Alameda County Medical Center/Highland Hospital (2006) "This is a serious, comprehensive, authoritative and highly readable textbook on a most relevant and challenging topic – the search for blood substitutes. ...The Editor and publishers have clearly given considerable thought to the readability as well as the academic rigour of the 46 chapters and 548 pages. In this reviewer’s opinion, they have been most successful. The font and the page layouts are easy on the eye, the illustrations of good quality, and the references for each chapter are comprehensive and up to date. The potential readership for this book will undoubtedly be broadly based. This is a quality text book, and, although it is always difficult to define quality, we do recognise it when we come across it." - Professor Ken Taylor, British Heart Foundation Professor of Cardiac Surgery, University of London and Director of Cardiac Services, Hammersmith Hospital, London, UK