• Christopher Bialas, Christopher Moser, and Carrie A Sims.
• From the Department of Biochemistry and Biophysics (C.B., C.M., C.A.S.), Johnson Research Foundation, Penn Acute Research Collaboration (C.A.M.), and Division of Trauma, Surgical Critical Care, and Emergency Surgery (C.B., C.A.M.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
• J Trauma Acute Care Surg. 2019 Jul 1; 87 (1S Suppl 1): S48-S58.

AbstractPacked red blood cells are a critical component in the resuscitation of hemorrhagic shock. The availability of donor-derived blood products, however, suffers from issues of supply, immunogenicity, and pathogenic contamination. Deployment in remote or austere environments, such as the battlefield, is further hindered by the inherent perishability of blood products. To address the significant limitations of allogenic packed red blood cells and the urgent medical need for better resuscitative therapies for both combat casualties and civilians, there has been significant research invested in developing safe, effective, and field deployable artificial oxygen carriers. This article provides a comprehensive review of the most important technologies in the field of artificial oxygen carriers including cell-free and encapsulated hemoglobin-based oxygen carriers, perfluorocarbon emulsions, natural hemoglobin alternatives, as well as other novel technologies. Their development status, clinical, and military relevance are discussed. LEVEL OF EVIDENCE: Systematic review.

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