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REVIEW
HIGHLIGHTED TOPIC
The Physiology and Pathophysiology of the Hyperbaric and Diving Environments
Department of Anesthesiology and Emergency Medicine, Virginia Commonwealth University Reanimation Engineering Shock Center, Richmond, Virginia
ABSTRACT
Perfluorocarbon (PFC) emulsions are halogen-substituted carbon nonpolar oils with resultant enhanced dissolved respiratory gas (O2, N2, CO2, nitric oxide) capabilities. In the first demonstration of enhanced O2 solubility, inhaled PFC could sustain rat metabolism. Intravenous emulsions were then trialed as "blood substitutes." In the last 10 yr, biocomputational modeling has enhanced our mechanistic understanding of PFCs. Contemporary research is now taking advantage of these physiological discoveries and applying PFCs as "oxygen therapeutics," as well as ways to enhance other gas movements. One particularly promising area of research is the treatment of gas embolism (arterial and venous emboli/decompression sickness). An expansive understanding of PFC-enhanced diffusive gas movements through tissue and vasculature may have analogous applications for O2 or other respiratory gases and should provide a revolution in medicine. This review will stress the fundamental knowledge we now have regarding how respiratory gas movements are changed when intravenous PFC is present.
decompression sickness; gas embolism; oxycyte; oxygen delivery
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