Application of Acute Non-isovolemic Hemodilution for Spinal Surgery_West China Medical Journal

Authors：

 LIWei , LIUWen-zhi , ZHUYue-hao , LIQuan-lin , DENGYi-jiang

Department of Anesthesiology, Affiliated Hospital of Panzhihua University/Chinese Traditional and Western Medicine Hospital of Panzhihua City, Panzhihua, Sichuan 617000, P. R. China;

Corresponding author：

Keywords：

Acute nomovolemic hemodilution; Acute hypervolemic hemodilution; Acute non-isovolemic hemodilution; Spinal surgery; Autologous blood; Saving blood

DOI：

10.7507/1002-0179.20140622

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effect of acute non-isovolemic hemodilution (ANIH) on spinal surgery. Methods From January 2012 to July 2013, 80 patients scheduled for spinal surgery were enrolled. The patients were randomized into four groups, with 20 in each group. Patients in group A were infused with Ringer's injection and polygeline for fluid loss, physiological needs and blood loss. In group B, the patients were infused with acute hypervolemic hemodilution. In group C, patients were infused with acute nomovolemic hemodilution. In group D, patients were infused with ANIH. The hemodynamics and arterial blood gas indexes were detected in all the patients. Results The mean blood pressure in group A and C was significantly more stable than that in group B and D. The central vein pressure in group B and D was significantly higher than that in group A and C after hemodilution (P<0.05), while the hematocrit in group B and D was significantly lower than that in group A and C (P<0.05). Allogeneic blood transfusion was performed in group A and B, while it was not performed in group C and D. Conclusion ANIH can reduce the volume of blood loss during spinal surgery, and it is safe.

Citation： LIWei, LIUWen-zhi, ZHUYue-hao, LIQuan-lin, DENGYi-jiang. Application of Acute Non-isovolemic Hemodilution for Spinal Surgery. West China Medical Journal, 2014, 29(11): 2063-2068. doi: 10.7507/1002-0179.20140622 Copy

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1. 邓硕曾, 刘进. 血液保护与输血安全[M]. 成都:四川科学技术出版社, 2007:125-164.
2. Carvalho B, Ridler BM, Thompson JF, et al. Myocardial ischaemia precipitated by acute normovolaemic haemodilution[J]. Transfus Med, 2003, 13(3):165-168.
3. Kreimeier U, Messmer K. Perioperative hemodilution[J]. Transfus Apher Sci, 2002, 27(1):59-72.
4. 田玉科. 围术期输血指南[J]. 中国继续医学教育, 2011, 3(10):124-128.
5. Brecher ME. Technical Manual[M]. 15th ed. Bethesda:America Association of Blood Banks, 2005:633-661.
6. Kumar R, Chakraborty I, Sehgal R. A prospective randomized study comparing two techniques of perioperative blood conservation:isovolemic hemodilution and hypervolemic hemodilution[J]. Anesth Analg, 2002, 95(5):1154-1161.
7. 陈培敏, 谢红, 李红, 等. 急性非等容性血液稀释的临床研究[J]. 中国血液流变学杂志, 2003, 3(13):294-297.
8. 王清秀, 靳风玲, 金清尘, 等. 手术病人对急性等容血液稀释的耐受程度[J]. 中华麻醉学杂志, 1997, 17(11):652-655.
9. 王建珍, 薄志华, 李蔚波, 等. 急性等容量血液稀释在骨关节手术中应用[J]. 中国临床医学, 2010(2):254-256.
10. 黄建华, 卢泽安. 七氟醚吸入全麻联合急性高容量血液稀释对老年人血流动力学和脑氧代谢的影响[J]. 临床医学, 2010, 30(5):88.
11. 姚泰. 生理学[M]. 5版. 北京:人民卫生出版社, 2006:81-85.
12. Van Daele ME, Trouwborst A, Van Woerkens LC, et al. Transesophageal echocardiographic monitoring of preoperative acute hypervolemic hemodilution[J]. Anesthesiology, 1994, 81(3):602-609.
13. 董庆龙, 温晓晖, 欧阳葆怡. 急性高容量血液稀释对血液动力学及血液流变学的影响[J]. 中华麻醉学杂志, 2001, 21(5):8-11.
14. 叶占勇, 吴勤, 刘合年, 等. 急性高容血液稀释对红细胞流变学的影响[J]. 四川医学, 2007, 28(3):247-248.
15. 于布为, 顾敏杰, 薛庆生. 急性超容量血液稀释对氧供、氧耗、循环血容量和血管外肺水的影响[J]. 临床麻醉学杂志, 2003, 19(1):23-26.
16. 李前辉, 王玲, 吴青华, 等. 术前急性高容量血液稀释对患者内稳态的影响[J]. 实用医药杂志, 2010(1):21-24.
17. 张象麟. 药物临床信息参考[M]. 成都:四川科学技术出版社, 2007:1242-1243.

West China Medical Journal

Application of Acute Non-isovolemic Hemodilution for Spinal Surgery

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