ABSTRACT
BACKGROUND: Although blood donation by healthy people can relieve the urgent need of clinical blood to some extent, it is impossible to fundamentally solve the problem of blood shortage and blood safety by relying solely on blood donation by healthy people. OBJECTIVE: In combination with the significance of the development of biological oxygen-carrying therapeutics, to expound the unique characteristics of biological oxygen-carrying therapeutics, and to summarize the research status and application progress of biological oxygen-carrying therapeutics in recent years, in order to provide a certain theoretical basis for further research on the role and clinical application of biological oxygen carrying therapeutic agents. METHODS: The authors searched the relevant articles published from January 2015 to August 2019 in the databases of CNKI, Wanfang and PubMed. The keywords were “blood substitute, hemoglobin oxygen carrier, artificial blood, oxygen-carrying therapeutic agent” in English and Chinese. Types of search literature included original research and reviews. Initially 418 articles were included, and finally 46 eligible articles were classified and reviewed. RESULTS AND CONCLUSION: The biological oxygen-carrying therapeutic agent has a good clinical effect. It can maintain blood osmotic pressure, acid-base balance and blood volume, and also has good oxygen-carrying capacity. It can deliver oxygen to local hypoxic tissue for a long time. It is also easy to store and transport. Biological oxygen-carrying therapeutic agents have been widely used in surgery, which are of great help to expand blood volume and accelerate postoperative recovery. Therefore, the development of biological oxygen-carrying therapeutic agents is of great significance for surgical trauma and resuscitation, hemorrhagic shock, malignant anemia, myocardial infarction and other diseases. It shows a good clinical application prospect.
ABSTRACT
Objective To observe the characteristics of changes in tissue oxygen partial pressure in Zusanli (ST36) acupoint and related organs in acute respiratory distress syndrome (ARDS), and to clarify the correlation between oxygenation of local tissue and systemic oxygenation and the correlation between oxygen metabolism of acupoint tissues and related organ tissues.Methods Twenty healthy New Zealand white rabbits were selected and divided into an ARDS model group and a control group, according to random number table method, 10 in each group. Oleic acid (0.08 - 0.1 mL/kg) intravenous injection was used to replicate the ARDS animal model. Only tracheotomy, mechanical ventilation, insertion of arterial/venous catheter, etc other manipulations were conducted, and no oleic acid was injected in the control group. Tissue oximeter was used to determine the fraction of inspired oxygen (FiO2), when FiO2 was 0.21 and 1.00 respectively, the tissue oxygen partial pressure (PtO2) in Zusanli acupoint, stomach and liver was measured. Meanwhile, the blood gas analyses of arterial blood and mixed venous blood were carried out to calculate the oxygen extraction rate (O2ER).Results When FiO2 was equal to 0.21, the levels of PtO2 in Zusanli acupoint, stomach and liver of the ARDS model group were significantly higher than those of the control group in the same period; the partial pressure of oxygen arterial blood (PaO2), partial pressure of oxygen in mixed venous blood (PvO2), arterial oxygen saturation (SaO2), mixed venous oxygen saturation (SvO2) and O2ER of the ARDS model group were significantly lower than those of the control group over the same period. When FiO2 was equal to 1.00, PtO2, PaO2, SaO2 and O2ER in Zusanli acupoint, stomach and liver were increased compared with those when FiO2 was 0.21 in both groups, and the increase of PtO2 and O2ER in Zusanli acupoint, stomach and liver was more significant in the ARDS model group [PtO2 (kPa): Zusanli acupoint: 16.75±2.12 vs. 13.80±1.83, stomach: 16.45±1.33 vs. 13.35±1.25, liver: 16.43±1.45 vs. 13.45±1.36, O2ER: (36.14±0.97)% vs. (30.81±1.01)%]; the increase of PaO2, SaO2 and SvO2 was more significant in the control group [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 682.02±50.32 vs. 159.32±40.17, SaO2: 1.00±0.00 vs. 0.98±0.01, SvO2: 0.69±0.01 vs. 0.63±0.03, allP < 0.05]. The indexes under FiO2 0.21 compared to those under FiO2 1.00 in the same group, it was shown that when FiO2 1.00, PvO2 was increased in the ARDS model group, but decreased in the control group, the difference between the two groups being statistically significant (mmHg: 36.00±2.83 vs. 42.50±1.70,P < 0.05). Besides, PtO2 in Zusanli acupoint was positively correlated to that in stomach (r = 0.963,P < 0.001).Conclusions When ARDS is under the condition of systemic oxygen delivery disorder, the demand of organ tissues for oxygen is significantly increased, but the oxygen utilization is impaired obviously, which is possibly related to the cellular mitochondrial dysfunction. There is good correlation between the tissue oxygen partial pressure of acupoint tissue and related organ tissue. The detection of oxygen in acupoint tissue has important guidance significance for monitoring the oxygen metabolism of related organ tissues.