Intraoperative Application Of Acute Normovolemic Hemodilution And The Effects On The Coagulation

Objective:To evaluate the effects of Acute normovolemic hemodilution on the coagulation and the clinic application result in the surgical patients.Methods:Fourty adults ASAâ… -â…¡patients undergoing major operation were divided into two groups randomly.ANH group(groupâ… ,n=20) and Control group(groupâ… ,n=20).Before the operation,ANH was performed by exchanging whole blood 400ml with an equal volume of HES(130/0.4) in gropsâ… after anesthesia induction.Blood samples were taken at before hemodilution(T₁),instant(T₂),before blood reinfusion(T₃) and after blood reinfusion(T₄) from central venous and comparison Hemoglobin(Hb),hematocrit(Hct),Platelet(Plt),Pulse oxygen saturation(SpO₂),(CVP),Pressure of end-tidal carbon di-oxide(P_ETCO₂),proth rombin time(PT) inlernational Normalized ratio(INR),vated partial thromboplastln time(APTT},Fibrinogen (FBG).Statistics the Urine,Blood transfusion and the amount of Infusion in the operation.Control the indicators at T₁,T₂,T₃,T₄ in groupâ… .The change of indicators between T₂,T₃,T₄ and after operation in groupâ…¡.And to control the demand for blood allogeneic between two group patients.Results:(1)Hb and Hct were significantly decreased 34%after hemodilution(P＜0.01),To achieve the objective of the moderate hemodilution.(2)Compared with Time point T₁,At Point T₂ and Point T₃ APTT were significantly longer,and INR was significantly greater,and FBG were significantly devreased,but all of this were in the normal range.(3) Hb,Hct,Plt in the T₁,T₂,T₃ and after operation in groupâ…¡were significantly decreased to the preoprative(P＜0.01).Compare T₄ with T₂,T₃ the blood coagulation parameters and components have improved.But not reached the level of T1.(4)T₄ compare with the groupâ…¡the time after operation there were significantly greater on the monitoring indicators(P＜0.01).All coagulation parameters and blood components were lower than T₄.Conclusion:Hb,Hct and Plt can be decreased remarkably by ANH.The function of coagulation was decreased significantly which was improved after blood reinfusion.ANH is safe and effective for decreasing and even avoiding homologous blood transfasion.