Effect Of Acute Isovolemic Hemodilution In Cardiopulmonary Bypass

Objective :To investigate the clinical effect of acute isovolemic hemodilution(ANH)on blood protection in cardiopulmonary bypass(CPB)cardiac surgery.Methods : Sixty patients who underwent cardiac valve surgery under CPB in The Cardiothoracic Surgery Department of Affiliated Hospital of Youjiang Medical College for Nationalities from January 2020 to August 2021 were enrolled and randomly divided into observation group(group A)and control group(group B),with 30 patients in each group.Group A received ANH for blood reserve,and group B received conventional surgery without blood reserve.Hb,HCT,PLT,coagulation function indicators(PT,APTT,Fbg),postoperative drainage volume,transfusion volume,complication rate,etc.,were monitored in 2 groups.Results:(1)The blood transfusion volume and postoperative drainage volume in group A were less(P < 0.05),with statistical differences;The retest(Hb,HCT)24 hours after operation and retest(Hb,HCT)at discharge in group A were significantly better than that in group B(P < 0.05),and the complication rate was lower than that in group B(P < 0.05),the difference was statistically significant.The duration of intensive care unit and hospital stay in group A were significantly shorter(P <0.05),and there was no statistical difference in PLT before surgery,24 hours after surgery and before discharge between the two groups(P >0.05).(2)There were no significant differences in preoperative coagulation function indexes between the two groups(P > 0.05),and all monitoring indexes of patients immediately after surgery were abnormal to varying degrees.Compared with before surgery,PT and APTT were prolonged in both groups,but there was no significant difference in PT and APTT values between the two groups(P > 0.05).Fib in 2 groups was lower than before operation,but the difference was not statistically significant(P > 0.05).Conclusion:ANH is feasible in open heart surgery.It can protect partial blood integrity,reduce allogeneic blood infusion in perioperative period and shorten the recovery period of patients.It is an effective blood conservation strategy.