Chronic Anemia

Chronic anemia would not seem to be a good indication for blood substitutes. First, patients usually adapt to chronic anemia just as high-altitude natives seem to become acclimatized to chronic hypoxia. The inability of the currently developed blood substitutes to provide coagulation factors, platelets or leukocytes would not seem to be a major drawback, especially in patients with chronic hemolysis, red cell aplasia, cancer, or other types of chronic disease.

If a red cell substitute were developed for chronic anemia, it would need to have the longest possible plasma retention to eliminate the need for excessively frequent infusions. The products that might be candidates to fill this need would be encapsulated or conjugated hemoglobin or derivatives with a very high molecular weight. Most efforts have been directed toward development of perfluorocarbons with short retention times, and of hemoglobin solutions with intermediate times.

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