Grondin P, Lussier J, Paiement B
Ann Anesthesiol Fr. 1976;17(12):1333-42.
Hemodilution during E.C.C. is into use for more than 15 years. Its interest is obvious (blood economy, beneficient action on viscosity, prevention of "sludging"), but opinions are different concerning the best level of hemodiultion. The authors defend the notion of a moderate dilution (hematocrit larger than or equal to 25 p. 100) required to maintain a high perfusion pressure. For atherosclerotic patients, they describe the hemodilution technics tried on more than 4,000 cases since 1964. The advantages of hemodilution concern on one hand the diminution or the disparition of drawbacks and complications due to the obtainment and to the administration of homologous blood and on the other hand the beneficient intrinsical effects of the blood dilution on the tissular perfusion. In convenients are those due to changes in the concentration of sodium, chlore and specially potassium which may be responsible of serious cardiac arrythmias. Because of increasing difficulties concerning the use of homologous blood (obtaining difficulties and complications relative to its use), the authors consider the utilization of autologous blood taken off before the operation on the patient and freezed.
体外循环期间的血液稀释已应用超过15年。其优势显而易见（节省血液、对血液粘度有有益作用、预防“血液淤滞”），但对于最佳血液稀释水平存在不同观点。作者支持适度稀释的观点（血细胞比容大于或等于25%），以维持较高的灌注压力。对于动脉粥样硬化患者，他们描述了自1964年以来在4000多例病例中尝试的血液稀释技术。血液稀释的优点一方面在于减少或消除因获取和输注同源血而产生的缺点和并发症，另一方面在于血液稀释对组织灌注的有益内在作用。不利之处在于钠、氯特别是钾浓度的变化可能导致严重的心律失常。由于使用同源血的困难不断增加（获取困难以及与其使用相关的并发症），作者考虑使用在患者手术前采集并冷冻的自体血。
