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Substances: Artificial oxygen carriers and plasma expanders

» Plasma Expanders (PEx)

Plasma expanders are used to increase (expand) the volume of plasma in the blood. Examples include Haemaccel, Albumex, Gelofusine and more recently Dextran 70 and Hydroxy-ethyl starch (HES). They are mainly used in medicine to replace fluid in cases of severe shock, as may occur with blood or fluid loss in surgery.

Endurance sports such as cycling and cross-country skiing do not allow athletes to compete who have high haematocrit and haemoglobin levels in their blood. Some athletes may use plasma expanders in an attempt to reduce high hematocrit levels, while maintaining elevated total blood volume.

Some athletes may use plasma expanders in an attempt to mask blood testing detection of erythropoietin (EPO).

Side effects

Side effects include allergic reactions and anaphylactic shock (a severe form of generalised allergic reaction that can result in death).

» Artificial Oxygen Carriers

Artificial oxygen carriers are chemicals used to increase the ability to carry extra oxygen in the blood. Examples include perflurocarbons (PFCs), haemoglobin based oxygen carriers (HBOCs) and liposome (fatty membrane) encapsulated haemoglobins (LEHs).

Artificial oxygen carriers are useful when human blood is not available, the risk of blood infection is high or when time to properly undertake cross-matching donated blood with a recipient is short. Such products are still in development and although improvements are being made, more research and development is needed before these products will be useful to humans in clinical medicine.

There are some reports of athletes using these products to increase the oxygen carrying capacity of their blood. There is no concrete evidence to support these claims and these drugs are not in general use.

Side effects

Side effects significantly vary between the PFCs and the HBOCs. They can be serious, as it is difficult to measure correct doses.
Side effects of PFCs include transient fever, reduction in the platelet count, and potential overloading of phagocyte cells. Side effects of HBOCs include hypertension, vasoconstriction, kidney damage, and iron overload.

Status in Sport

Artificial oxygen carriers and plasma expanders are prohibited under the World Anti-Doping Code 2007 Prohibited List (effective from 01/01/07).

 

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