ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, September 18, 1996 TAG: 9609180128
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: NEW RIVER VALLEY
DATELINE: WASHINGTON
SOURCE: Associated Press
MEMO: ***CORRECTION***
Published correction ran on September 19, 1996.
In a story in Wednesday's paper, The Assoicated Press erroneously
reported that Cook County Hospital in Chicago would be a site for the
testing of a potential substitute for human blood. Researchers heading
the project have not yet formally applied to do the testing at Cook
County.
Trauma patients rushed to Chicago's Cook County Hospital soon may awaken to discover they're pioneers in the search for artificial blood, as a red liquid that looks like real blood - but isn't - drips into their veins.
Doctors at Cook County and 20 other emergency rooms nationwide later this fall will begin the first mass testing of 850 patients for a potential substitute for human blood. A competing firm is seeking government approval to test hundreds of additional patients.
No one expects these first attempts to supplant nature. But the hope is that artificial blood will save lives when doctors run short on the real stuff.
``If blood is unavailable, and that does happen, this provides a bridge until you can get it,'' said Richard DeWoskin of Northfield Laboratories Inc., which is trying to get approval for tests. DeWoskin expects artificial blood one day to help in the military, developing countries and in the ``urban battlefield'' of inner cities.
But some experts are skeptical.
There are health risks from the substitute to be tested, Baxter HealthCare's HemAssist, some scientists believe. It raises blood pressure through complex blood vessel changes that Dr. Gerald Sandler, director of Georgetown University Medical Center's blood bank, fears could cause harm. The Food and Drug Administration, meanwhile, is examining some reports that artificial blood might shut down the body's capillary system.
``We don't want to impose upon the public something that could be more dangerous'' than today's overwhelmingly safe blood donations, said Dr. Joseph Fratantoni, the FDA's hematology chief. ``Caution is the word here.''
The search for artificial blood dates to the 17th century, when doctors unsuccessfully tried transfusions with animal blood or even wine.
The quest gained urgency in the 1980s when thousands caught the AIDS virus from tainted blood, a risk that today has plummeted to less than one case per 450,000 pints of blood.
Although blood now is largely safe, it stays fresh only weeks after donation, hospitals sometimes face shortages and patients must receive the right blood type or risk a deadly allergic reaction.
So scientists are brewing nonallergenic substitutes that would stay fresh for up to a year, using everything from outdated human blood to genetically engineered bacteria and even an oily byproduct of Teflon.
Six firms have done early testing in a small number of Americans to see how well the substances carry oxygen to tissues - blood's main function.
Now, the FDA has approved the first large-scale study of a potential blood substitute, HemAssist, and is considering allowing a similar study of Northfield's PolyHeme. The 20 other hospitals, besides Cook County, have yet to be chosen.
Both liquids are made from outdated blood. Scientists stripped human hemoglobin, the blood protein that carries oxygen, out of the cell coating that makes it cause allergic reactions and then chemically modified it to stay fresh longer.
The question is whether it can help trauma patients survive or reduce the amount of real blood they need.
Baxter is banking on HemAssist as a ``resuscitation fluid,'' said lead researcher, Dr. Edward Sloan of the University of Illinois, Chicago.
Take a car crash victim in shock from blood loss. Ambulance workers now infuse pints of salt water to keep the veins from collapsing until the patient reaches the hospital and blood supplies. But salt water carries no oxygen to keep organs alive - and large volumes can actually damage organs. So even when blood revives the most severe trauma patients in the emergency room, 40 percent still ultimately die from organ damage.
Small amounts of HemAssist appear to raise blood pressure as much as large volumes of salt water - while also providing oxygen, explained Sloan, who heads the study of 850 trauma patients.
Northfield, on the other hand, is focusing on preserving donated blood. In a preliminary study, 10 patients who got 4.6 pints of PolyHeme during surgery needed 4.6 fewer pints of real blood. Now Northfield is seeking FDA permission to study up to 400 surgery patients.
This fake blood lives in a person's bloodstream just a few days before ceasing to be effective. It doesn't clot or fight infections like real blood does, so it's not a permanent replacement.
Sloan forecasts a day when competing blood substitutes are stocked in emergency rooms nationwide. ``We believe this will save lives.''
LENGTH: Medium: 91 linesby CNB