Application of Acute Non-isovolemic Hemodilution for Spinal Surgery_West China Medical Journal

Authors：

 LIWei , LIUWen-zhi , ZHUYue-hao , LIQuan-lin , DENGYi-jiang

Department of Anesthesiology, Affiliated Hospital of Panzhihua University/Chinese Traditional and Western Medicine Hospital of Panzhihua City, Panzhihua, Sichuan 617000, P. R. China;

Corresponding?author：

Keywords：

Acute nomovolemic hemodilution; Acute hypervolemic hemodilution; Acute non-isovolemic hemodilution; Spinal surgery; Autologous blood; Saving blood

DOI：

10.7507/1002-0179.20140622

Video：

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Objective To investigate the effect of acute non-isovolemic hemodilution (ANIH) on spinal surgery. Methods From January 2012 to July 2013, 80 patients scheduled for spinal surgery were enrolled. The patients were randomized into four groups, with 20 in each group. Patients in group A were infused with Ringer's injection and polygeline for fluid loss, physiological needs and blood loss. In group B, the patients were infused with acute hypervolemic hemodilution. In group C, patients were infused with acute nomovolemic hemodilution. In group D, patients were infused with ANIH. The hemodynamics and arterial blood gas indexes were detected in all the patients. Results The mean blood pressure in group A and C was significantly more stable than that in group B and D. The central vein pressure in group B and D was significantly higher than that in group A and C after hemodilution (P<0.05), while the hematocrit in group B and D was significantly lower than that in group A and C (P<0.05). Allogeneic blood transfusion was performed in group A and B, while it was not performed in group C and D. Conclusion ANIH can reduce the volume of blood loss during spinal surgery, and it is safe.

Citation： LIWei, LIUWen-zhi, ZHUYue-hao, LIQuan-lin, DENGYi-jiang. Application of Acute Non-isovolemic Hemodilution for Spinal Surgery. West China Medical Journal, 2014, 29(11): 2063-2068. doi: 10.7507/1002-0179.20140622 Copy

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2. Carvalho B, Ridler BM, Thompson JF, et al. Myocardial ischaemia precipitated by acute normovolaemic haemodilution[J]. Transfus Med, 2003, 13(3):165-168.
3. Kreimeier U, Messmer K. Perioperative hemodilution[J]. Transfus Apher Sci, 2002, 27(1):59-72.
4. 田玉科. 圍術期輸血指南[J]. 中國繼續醫學教育, 2011, 3(10):124-128.
5. Brecher ME. Technical Manual[M]. 15th ed. Bethesda:America Association of Blood Banks, 2005:633-661.
6. Kumar R, Chakraborty I, Sehgal R. A prospective randomized study comparing two techniques of perioperative blood conservation:isovolemic hemodilution and hypervolemic hemodilution[J]. Anesth Analg, 2002, 95(5):1154-1161.
7. 陳培敏, 謝紅, 李紅, 等. 急性非等容性血液稀釋的臨床研究[J]. 中國血液流變學雜志, 2003, 3(13):294-297.
8. 王清秀, 靳風玲, 金清塵, 等. 手術病人對急性等容血液稀釋的耐受程度[J]. 中華麻醉學雜志, 1997, 17(11):652-655.
9. 王建珍, 薄志華, 李蔚波, 等. 急性等容量血液稀釋在骨關節手術中應用[J]. 中國臨床醫學, 2010(2):254-256.
10. 黃建華, 盧澤安. 七氟醚吸入全麻聯合急性高容量血液稀釋對老年人血流動力學和腦氧代謝的影響[J]. 臨床醫學, 2010, 30(5):88.
11. 姚泰. 生理學[M]. 5版. 北京:人民衛生出版社, 2006:81-85.
12. Van Daele ME, Trouwborst A, Van Woerkens LC, et al. Transesophageal echocardiographic monitoring of preoperative acute hypervolemic hemodilution[J]. Anesthesiology, 1994, 81(3):602-609.
13. 董慶龍, 溫曉暉, 歐陽葆怡. 急性高容量血液稀釋對血液動力學及血液流變學的影響[J]. 中華麻醉學雜志, 2001, 21(5):8-11.
14. 葉占勇, 吳勤, 劉合年, 等. 急性高容血液稀釋對紅細胞流變學的影響[J]. 四川醫學, 2007, 28(3):247-248.
15. 于布為, 顧敏杰, 薛慶生. 急性超容量血液稀釋對氧供、氧耗、循環血容量和血管外肺水的影響[J]. 臨床麻醉學雜志, 2003, 19(1):23-26.
16. 李前輝, 王玲, 吳青華, 等. 術前急性高容量血液稀釋對患者內穩態的影響[J]. 實用醫藥雜志, 2010(1):21-24.
17. 張象麟. 藥物臨床信息參考[M]. 成都:四川科學技術出版社, 2007:1242-1243.

West China Medical Journal

Application of Acute Non-isovolemic Hemodilution for Spinal Surgery

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