The Effect Of Novel Hetastarch 130/0.4 On Hemodynamics And Coagulation Under AHH

Backgrouds and ObjectiveThe risks associated with transfusion of homologous blood hav provide the impetus for the development if technique to minimize thansfusions. Preoperative autologous blood donation, meticulous surgical technique, intra-and postoperative salvage of the patient,s blood and its retransfusion, and acceptancce of lower hemoglobin levels have all been used toavoid homologous blood danation. These years, wit the development of the study on the mechanism of hemodilution, preoperative hemodilution has become one of the most frequently used and effective for blood saving. It include twomajor methods: Acute Normovolemic Hemodilution(ANH) and Acute Hypervolemic Hemodilution(AHH).AHH is a new way of saving blood that wasput forth in the nineties of twentieth century,compared with ANH,AHH can save time and cost, and reduce contamination of blood, it will be more widely used in clinic gradually. The homemade HES and HES imports both in the domestic market, it is used for volume instead of the treatment. We have researched, observed the infection for the hemodynami- cs and coagulation when the 6% hetastarch, 130/0.4 used to AHHMethod:Choose 60 of the patients whom are from ASAâ… -â…¡, and separate them into HES (homemade), HES (import)and Ringer's solution, 20 people for each group. Put 8mm/kg Compound Sodium Lactate and Glucose Injection before the trachea cannula to supplement ambrosia and the physiological need. After the inducement of the General Anesthesia trachea cannula, put the HESa 20% in (25±5)mins.Observed CVP, HR, HB, HCG, PT, TT, APTT, FiB into four periods: T₀: Equilibrium liquid, T₁: AHH., T₂: After AHH 30mins, T₃: After 60minsResult:1. General document, three groups of the patients'Age, weight and basic HCT, no difference statistics (p<0.05)2. After AHH, three groups'HCT have fallen off about 30%. To reach the medium Hemodilution.3. Compare with the AHH. The PT, APTT of the A group and B group has evidently fallen off after AHH. Compare of the statistics inside of the groups between the A group and B group. A group and B group'Fib was significantly lower than C group values.(P<0.05)4. Hemodynamics alloeosis: SBP, DBP,HRandCVP hsa the no difference in T₁ (P>0.05). The A group and B group of patients'HR have been more rising in T₁-T₃ than T₀. SBP and DBP in T₁ are higher than T₀. ButT₂and T₃ lower than T₀. But still in the normal area. Compare the groups T₁-T₃ of significance time difference. (P>0.05) C group significantly decreased T₃SBP and DBP(P<0.05),the HR is higher than T₃ of the A group and B group.5. HB, HCT the change of the index, three groups of the patients HB, HCT. Compare with the T₃ and T₀ have fallen off (P<0.05). Compare with HB, HCT. T₀, T₃ of significance time difference. (P>0.05) HCT of A group and B group was significantly lower than C Group(P<0.05)。Conclusion:1. Expand blood volume before operation, adding the tolerance of body blood loss. Reduce infusion effectively.2. The homemade HES has as the good expansion effect as the import of the HES. There is no effect with blood coagulation system. The homemade HES which the good choice instead of the blood plasma.3 The 6%hetastarch, 130/0.4 can be used for AHH, which caused an obvious extension of PT and APTT, beyond the normal range and FIB decreased significantly, but in the normal range.