Kikuchi K, Konishi A, Terashima M, Tamii H, Fujii M
Department of Anesthesia, New Tokyo Hospital, Matsudo.
Masui. 1994 Nov;43(11):1701-8.
In order to avoid blood transfusion in patient, we have been carrying out hypervolemic hemodilution (HH) with HES and Ringer's lactate without blood withdrawal. We studied the hemodynamics during hypervolemic hemodilution in adult mongrel dogs. The dogs were divided into two groups; control group (group C) and nitroglycerin group (group N) in which nitroglycerin was administrated at 1 microgram.kg-1.min-1. During HH, CVP, PAP, PCWP increased remarkably, and they were lower in group N than in group C, and CO increased in group N more than in group C. Though by the acute hemodilution Hct decreased to 30%, PaO2/FIO2, pH, and SvO2 remained within normal ranges. We conclude that HH is a very useful technique to avoid blood transfusion. However, during HH the excessive volume loading is associated with significant increase in CVP and PCWP, and the vasodilating therapy is effective to reduce the volume overloading.