The comparison of feasibility of different plasma substitutes during preoperative acute hypervolemic hemodilution.
- VernacularTitle:不同血浆代用品术前急性超容血液稀释可行性的比较
- Author:
Wei WEI
;
Xiangde ZHENG
;
Quan GONG
- Publication Type:Journal Article
- Keywords:
Hemodilution;
Hetastarch;
Gelatin;
Polygeline
- From:
Chinese Journal of Anesthesiology
1996;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of three different plasma substitutes, 6% hydroxyethyl starch (HES 200/0.5), 4% Gelofusine and 5% Polygeline, on blood coagulation and arterial blood gases and electrolytes during acute hypervolemic hemodilution (AHHD) . Methods Seventy ASA Ⅰ - Ⅱ adult patients undergoing elective orthopedic surgery with the intraoperative blood loss predicted to exceed 500 ml were entered in this study. Radial artery was cannulated for BP monitoring and blood sampling before induction of anesthesia. Anesthesia was induced with fentanyl 3 ?g?kg-1, propofol 2 mg?kg-1 and atracurium 0.5 mg? kg-1 and maintained with enflurane (1-2 MAC) . The patients were mechanically ventilated ( VT= 10 ml? kg-1 , RR = 12 bpm) after tracheal intubation. Internal jugular vein was cannulated after induction of anesthesia for CVP monitoring. After induction of anesthesia the patients were randomized to receive 20 ml?kg-1 of either 6% HES (group H, n = 20), 4% Gelofusine (group G, n = 20), 5% Polygeline (group P, n = 20) or lactated Ringer's solution (group R, n = 10) within 20-40 min. Arterial blood samples were taken before AHHD, at the end of and 30 min after the infusion of substitute for determination of activated coagulation time (ACT), thromboelastography (TEG) , blood gas analysis and plasma electrolytes. Blood volume expansion rate was calculated [ blood volume expansion rate = (Hct before AHHD - Hct after AHHD) / Hct before AHHD] .Results The four groups were comparable with respect to sex, age and body weight. Lactated Ringer' s solution was significantly less efficient in expanding intravascular blood volume than the 3 plasma substitutes, but there was no significant difference in blood volume expansion rate among group H, G and P. CVP increased significantly after AHHD compared with the baseline value before AHHD in group H, G and P (P
