Effect of acute normovolemic hemodilution on coagulation
- VernacularTitle:急性等容性血液稀释与凝血状态
- Author:
Geng WANG
;
Xinmin WU
- Publication Type:Journal Article
- Keywords:
Hemodilution;
Thrombelastography;
Blood coagulation
- From:
Chinese Journal of Anesthesiology
1997;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the changes in coagulation induced by acute normovolemic hemodilution Methods Twenty ASA Ⅰ Ⅱ patients scheduled for elective surgery were divided into two groups: HES group and GEL group in which hydroxyethyl starch(HES) or succinylated gelatin (GEL) was used as the hemodilution fluid Patients with coagulation abnormalities or kidney dysfunction were excluded from the study Anesthesia was induced with propofol,fentanyl and vecuronium and maintained with inhalation of isoflurane and nitrous oxide and intermittent intravenous boluses of fentanyl and vecuronium The patients were mechanically ventilated and PaO 2 and PaCO 2 were maintained within normal range After induction blood was withdrawn from internal jugular vein and collected in standard blood bags containing anticoagulant and at the same time replaced with HES (equal volume) or GEL (1 5 times the volume of blood withdrawn) The amount of blood withdrawn was estimated from the following equation:blood volume withdrawn=body weight(kg)?60?(Hct 0 Hct 1)/Hct M,where Hct 0=patient′s initial Hct, Hct 1=desired end point Hct and Hct M=the average of Hct 0 and Hct 1 Blood routine,prothrombin time(PT),activated partial thromboplastin time(APTT) and fibrinogen level were checked and thromboelastography(TEG) was performed 15 min before and after hemodilution Results The amount of blood withdrawn ranged between 1000 1100ml Hb was still above 80g/L after hemodilution The decreases in Hb and Hct were significant in both groups (P
