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Acute normovolemic hemodilution.急性等容血液稀释
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A randomized trial of perioperative hemodilution versus transfusion of preoperatively deposited autologous blood in elective surgery.择期手术中围手术期血液稀释与术前储存自体血输血的随机试验。
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择期大手术患者的急性等容血液稀释

ACUTE NORMOVOLEMIC HEMODILUTION IN PATIENTS UNDERGOING ELECTIVE MAJOR SURGERY.

作者信息

Ashok Y, Roy P S, Goyal B K

机构信息

Graded Specialist (Anaesthesia), Military Hospital, Bareilly - 243 001.

Classified Specialist (Anaesthesia), Military Hospital, Bareilly - 243 001.

出版信息

Med J Armed Forces India. 2000 Jul;56(3):216-218. doi: 10.1016/S0377-1237(17)30170-3. Epub 2017 Jun 10.

DOI:10.1016/S0377-1237(17)30170-3
PMID:28790711
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5532054/
Abstract

Efficacy of acute normovolemic hemodilution in patients undergoing elective major surgery was studied with the aim to evaluate optimum technique, safety and utility in the service. Forty adult patients undergoing elective major surgery, who were in ASA GD I with preoperative haemoglobin more than 10.0g% were included in this study after a detailed explanation of the procedure and obtaining consent. 350-700 ml of patients' blood was collected before induction of anaesthesia and was kept in the operation theatre at room temperature. This was followed by rapid infusion of crystalloid calculated at the rate of 3ml for every ml of blood withdrawn. Intraoperative blood loss, serial haemoglobin assessment, change in pulse rate, blood pressure, SpO and urine output were carefully monitored. The blood was reinfused once haemostasis was secured at the end of surgery. All the vital parameters were maintained within normal limits throughout the procedure. This simple, easy and inexpensive technique was found to be very useful in obviating the necessity of other forms of blood transfusion and preventing all transfusion related hazards. It was found that this method has an important role in patients with uncommon blood groups and has an excellent patient acceptability. This technique has an important role in peripheral service hospitals, where formal blood bank facilities do not exist.

摘要

研究了急性等容性血液稀释在择期大手术患者中的疗效,目的是评估最佳技术、安全性和实用性。在详细解释手术过程并获得同意后,本研究纳入了40例择期大手术的成年患者,这些患者ASA分级为Ⅰ级,术前血红蛋白超过10.0g%。在麻醉诱导前采集患者350 - 700ml血液,并在手术室室温下保存。随后以每抽取1ml血液输注3ml晶体液的速率快速输注晶体液。仔细监测术中失血量、系列血红蛋白评估、脉搏率、血压、SpO₂和尿量的变化。手术结束止血后回输血液。整个手术过程中所有生命体征参数均维持在正常范围内。这种简单、易行且成本低廉的技术被发现对避免其他形式输血的必要性以及预防所有输血相关风险非常有用。发现该方法在稀有血型患者中具有重要作用,且患者接受度极佳。该技术在没有正规血库设施的基层医院具有重要作用。