There is a great clinical need for readily available volume replacement fluids with the property of oxygen transport. From the fluorocarbone emulsions only stromafree hemoglobin solutions seem to meet the essential requirements of oxygen transport and delivery at the tissue level. However, the high oxygen affinity and the short intravascular persistence have been preventing, up until now, the application of hemoglobin solutions for blood replacement.

Recently, a modified hemoglobin solution with a decreased oxygen affinity and a long intravascular persistence, has been produced by binding pyridoxalphosphate to the hemoglobin and its subsequent crosslinking. The hemodynamics and oxygen unloading capacity of this pyridoxalated polyhemoglobin have been investigated in a model of total blood exchange.