Perfluorocarbon Oxygen Carrier (PFC)
Perfluorocarbons are inert synthetic fluids that dissolve large volumes of oxygen and carbon dioxide, investigated as blood substitutes and infused as emulsions. First-generation products like Fluosol and later Oxygent reached trials but none achieved lasting approval. Their oxygen-carrying capacity makes them a doping concern; WADA prohibits artificial oxygen carriers.
01 Overview
Perfluorocarbon (PFC) emulsions carry oxygen dissolved in proportion to partial pressure, independent of haemoglobin, and can transiently boost oxygen delivery. Fluosol was briefly approved in the late 1980s for angioplasty support but withdrawn; Oxygent and others were studied as surgical blood substitutes but stalled over safety, including stroke signals in cardiac surgery trials.\n\nBecause they augment oxygen transport, PFCs are attractive doping agents and are explicitly prohibited by WADA as artificial oxygen carriers. In athletes their use is unmonitored and hazardous: they typically require breathing high supplemental oxygen to be useful, and carry risks of platelet reduction, flu-like reactions and thrombotic/embolic events.
02 Mechanism
Perfluorocarbon molecules physically dissolve and release oxygen and carbon dioxide down partial-pressure gradients; infused as an emulsion they supplement haemoglobin's oxygen transport, especially under high inspired oxygen.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Surgical blood substitute (trials) | 1.8–2.7 g/kg | IV | Trial dosing with high inspired oxygen; no approved athletic use |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Augmented oxygen transportIncreases the oxygen carried in plasma, supplementing haemoglobin, particularly when breathing enriched oxygen. | Extra dissolved O2 | Clinical | |
| Small particle size / tissue penetrationPFC emulsion droplets are far smaller than red cells, so they can perfuse capillaries partly occluded to normal blood. | Sub-micron droplets | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Stroke / thromboembolic eventsSome PFC blood-substitute trials showed increased stroke rates, halting development. | Life-threatening | Signal in surgery trials | Clinical | |
| Thrombocytopenia and flu-like reactionTransient drop in platelets and flu-like symptoms are common after PFC emulsion infusion. | Moderate | Common with emulsions | Clinical |