Anwendbarkeit und Grenzen der akuten normovolämischen Hämodilution

Coburg, A. J.; Husen, K.; Trentz, O.; Grosse, H; Pichlmayr, Ina; Pichlmayr, R.

doi:10.1007/978-3-662-05557-1_85

Cited by 4 publications

(6 citation statements)

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“…major general surgery [1,2,5,7,22,43,[48][49][50][51]. Furthermore, it is especially indicated in patients with polycythemia since, in addition to providing autologous blood in these patients, hemodilution per se has beneficial effects [23,52,53].…”

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confidence: 99%

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Acute limited normovolemic hemodilution: A method for avoiding homologous transfusion

1987

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Preoperative normovolemic hemodilution was introduced for clinical application by Messmer and co-workers. Preoperative blood withdrawal of 1,500-2,000 ml by an isovolemic exchange with colloids or crystalloids (3 times the volume of blood withdrawn), in order to maintain a constant circulating volume, is offset by an adequate increase of cardiac output and an unchanged systemic oxygen transport capacity despite a decreased oxygen content. Patients lose fewer red cells and more plasma intraoperatively. The retransfusion of autologous blood follows in the reverse order of collection after hemostasis is restored. The procedure is a safe and feasible method, which is not beset with the logistical problems of autologous blood predeposit and has the added advantage that fresh autologous blood is available at once for retransfusion. Provided that the contraindications are observed, the technique helps to reduce or even avoids the risks of homologous blood transfusion. The need for stored blood can be reduced by 20% to 90%, depending on the surgical procedure.

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mentioning

confidence: 99%

“…Increased safety alone would sufficiently justify autologous transfusion programs. One alternative to avoid or reduce the administration of homologous blood is autologous blood transfusion by means of acute preoperative hemodilution [1][2][3][4][5][6][7].…”

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confidence: 99%

Acute limited normovolemic hemodilution: A method for avoiding homologous transfusion

1987

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“…In accordance with the physiological and pathophysiological facts reviewed so far, Coburg [26], Coburg et al [27] and Pichl cause of the lowered viscosity [87], but in some cases probably also due to coagulation defects [117]. The reduced viscosity of the blood may also promote bleeding from a gastrointestinal ulcer, which stops following the transfusion of packed red cells [55].…”

Section: Intra-and Postoperative Observationsmentioning

confidence: 90%

“…It is now manifestly clear that this level of acute normovolemic anemia significantly reduces the buffer ca pacity of the patient against any oscillations of the depth of anesthesia, oxygen supply, body temperature, heart rate, blood pressure, blood volume, serum electrolyte and acidbase status [26,27,100,124], It is, there fore, imperative that variations of these pa rameters be promptly recognized and treated [63,72,100,117]. Continuous surveillance of heart rate, ECG, arterial and central ve nous pressure, hematocrit and diuresis is es sential.…”

Section: Intra-and Postoperative Observationsmentioning

confidence: 99%

“…(1) Even if the curve were correct, it would merely denote an overshoot of car-cardiac output [99], In acute anemia, this is probably the main explanation for the diverging reports of falling versus rising ar teriovenous oxygen differences [26,27,59,78,120,124], One procedure recommended for hemo dilution consists in the stepwise withdrawal of about one third of the patient's blood vol ume after the induction of anesthesia, this loss being replaced with PPF 1:1 plus Ring er's lactate 1:1 [5,65,[67][68][69], With a final hematocrit of 21-25%, cardiac output rose to about 170% of the baseline values and the arteriovenous oxygen extraction was constant or somewhat narrowed. Dilution diac output due to the increased fluidity of the blood, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Hemodilution - New Clothes for an Anemic Emperor

Lundsgaard-Hansen¹

1979

Vox Sanguinis

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This review deals with the rationale for the use of hemodilution in patients not subjected to open heart surgery. The claim for an optimum of circulatory oxygen transport at 30% hematocrit has been disproved; hemodilution thus simply means acute normovolemic anemia. Accordingly, it generates a cardiovascular strain and particularly jeopardizes cerebral and myocardial oxygen supply. Potentially serious clinical side effects have been reported. Hemodilution should therefore not be carried beyond the lower normal range for the hemoglobin or hematocrit level, i.e. 12-12.5 g% or 35-36%.

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Literatur

Reil¹,

Rehrmann²

1978

Messung Des Blutdurchflusses in Der Art. Carotis Interna Und Bestimmung Der Parameter Des Herz-Kreislaufsystems Sowie Des Cereb

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Anwendbarkeit und Grenzen der akuten normovolämischen Hämodilution

Cited by 4 publications

References 2 publications

Acute limited normovolemic hemodilution: A method for avoiding homologous transfusion

Acute limited normovolemic hemodilution: A method for avoiding homologous transfusion

Hemodilution - New Clothes for an Anemic Emperor

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