Acute hypervolemic hemodilution effect on oxygen metabolism and blood pharmacokinetics in patients undergoing acute laparotomy during induction of general anesthesia.

BACKGROUND/AIMS: To investigate acute hypervolemic hemodilution effect on oxygen metabolism and blood pharmacokinetics in patients undergoing acute laparotomy during Induction of general anesthesia.

METHODOLOGY

Forty ASA I-II patients undergoing acute laparotomy were randomly divided into 2 groups (n=20 each): Patients of group A received Voluven 7 ml/kg in 20 mins before induction and 8 ml/kg after induction. Patients of group B received 6 ml/kg/h Plasmalyte A. Hemodynamic parameters MAP, HR and CVP were collected at 6 set points during the surgery: T1: before AHH; T2: before anesthesia induction; T3: right intubation; T4: 10 min after intubation; T5: 20 min after intubation; T6: skin incision. Arterial and venous blood samples were taken for blood gas analysis and determination of lactic acid, Hb and Hct: T1: before AHH, T2: right after AHH, T3: 0.5 h after AHH, T4: l h after AHH. Arterial Oxygen Content (Ca02), Central Venous Oxygen Content (Ccv02) and Oxygen Extraction Ratio (ER02) were calculated.

RESULTS

The hemodynamic parameters were maintained within normal limits during operation in group A (P <0.05). CaO2, CcvO2, ERO2 and Lac between the two groups were no significant difference (P> 0.05). Compared with T1, CaO2/CcvO2 atT 24 reduced in both groups (P <0.05). Compared with group A, Hb and Hct in group B increased at T24 (P <0.05).

CONCLUSIONS

Acute hypervolemic hemodilution in patients undergoing acute laparotomy during Induction of general anesthesia have some preventive hypotension effect, more conducive to the smooth blood pharmacokinetics; Voluven induced expansion of applications is safe and effective, and has no effect on the body's metabolic rate of oxygen.