Lilleaasen P, Stokke O
Ann Thorac Surg. 1978 Feb;25(2):127-33. doi: 10.1016/s0003-4975(10)63505-9.
Two groups of patients underwent aortic valve replacement. Fifteen patients received moderate hemodilution (mean hematocrit, 27%) with 40% donor blood in the priming solution. Extreme hemodilution was used in 14 patients (mean hematocrit, 18%) with a nonhemic prime and withdrawal of blood at the start of operation. Both groups were given more than 7 liters of fluid during operation; donor blood was primarily used in the moderately diluted patients, and Ringer's acetate was primarily given to the other group. The diuretic response to this fluid load was much more pronounced in the extreme than in the moderate hemodilution group. Eighteen hours postoperatively, patients in the moderate and extreme hemodilution groups had an excess of about 2 and 1.5 liters of water, respectively. In the patients who had moderate dilution an average of 1,000 ml of erythrocytes disappeared from circulation; no such disappearance could be found in the other group. The moderate group showed significantly lower arterial PO2 postoperatively than the extreme group. There were, however, no differences between the two groups in mixed venous PO2 during perfusion or in acid-base and osmolality values.
两组患者接受了主动脉瓣置换术。15名患者在预充液中使用40%的供血进行中度血液稀释（平均血细胞比容为27%）。14名患者采用极重度血液稀释（平均血细胞比容为18%），预充液为无血预充，并在手术开始时抽血。两组患者在手术期间均输入超过7升的液体；中度稀释组主要输入供血，另一组主要输入醋酸林格液。极重度血液稀释组对该液体负荷的利尿反应比中度血液稀释组更为明显。术后18小时，中度和极重度血液稀释组患者分别多余约2升和1.5升的水分。中度稀释组患者循环中平均有1000毫升红细胞消失；另一组未发现此类红细胞消失情况。中度稀释组术后动脉血氧分压明显低于极重度稀释组。然而，两组在灌注期间的混合静脉血氧分压或酸碱及渗透压值方面无差异。
