Influence of crystalloid and colloid replacement solutions on hemodynamic variables during acute normovolemic hemodilution

Jones, Stephanie B.; Whitten, Charles W.; Monk, Terri G.

doi:10.1016/j.jclinane.2003.03.003

Cited by 42 publications

(21 citation statements)

References 19 publications

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“…It can be seen during volume replacement in emergency or intensive care medicine (1,15), is applied as standard practice during cardiopulmonary bypass (27), or is used in the form of normovolemic hemodilution as a clinical technique to reduce transfusion requirements in elective surgery (16,19). Hemodilution reduces the oxygen-carrying capacity of the blood with a decrease in hematocrit followed by a drop in peripheral resistance and an increase in venous return and cardiac output.…”

mentioning

confidence: 99%

Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution

Johannes

Mik²,

Nohé³

et al. 2007

American Journal of Physiology-Renal Physiology

121

122

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Johannes T, Mik EG, Nohé B, Unertl KE, Ince C. Acute decrease in renal microvascular PO 2 during acute normovolemic hemodilution. Am J Physiol Renal Physiol 292: F796 -F803, 2007. First published October 31, 2006 doi:10.1152/ajprenal.00206.2006.-Large differences in the tolerance of organ systems to conditions of decreased O2 delivery such as hemodilution exist. The kidney receives ϳ25% of the cardiac output and O2 delivery is in excess of the oxygen demand under normal circumstances. In a rat model of acute normovolemic hemodilution (ANH), we studied the effect of reduced hematocrit on renal regional and microvascular oxygenation. Experiments were performed in 12 anesthetized male Wistar rats. Six animals underwent four steps of ANH (hematocrit 25, 15, 10, and Ͻ10%). Six animals served as time-matched controls. Systemic and renal hemodynamic and oxygenation parameters were monitored. Renal cortical (c) and outer medullary (m) microvascular PO 2 (PO2) and the renal venous PO 2 (PrvO2) were continuously measured by oxygen-dependent quenching of phosphorescence. Despite a significant increase in renal blood flow in the first two steps of ANH, cPO 2 and mPO2 dropped immediately. From the first step onward oxygen consumption (V O2ren) became dependent on oxygen delivery (DO 2ren). With a progressive decrease in hematocrit, a significant correlation between PO 2 and V O2ren could be observed, as well as a PO2 gap between PO2 and P rvO2. Furthermore, there was a high correlation between V O2ren and RBF over a wide range of flows. In conclusion, the oxygen supply to the renal tissue is becoming critical already in an early stage of ANH due to the combination of increased V O2ren, decreased DO2ren, and intrarenal O 2 shunt. This has clinical relevance as recent publications reporting that hemodilution during surgery forms a risk factor for postoperative renal dysfunction.

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mentioning

confidence: 99%

Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution

Johannes

Mik²,

Nohé³

et al. 2007

American Journal of Physiology-Renal Physiology

121

122

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“…for each 1 ml of blood removed; 3 ml of crystalloid solution was infused [12] . Lactated Ringer solution is preferable because it has a lower incidence of acidosis, (a larger charge of chlorine in the saline solution tends to cause hyperchloremic metabolic acidosis) [13,14] . The bag (s) should be gently agitated to ensure adequate mixing.…”

Section: Materials Methodsmentioning

confidence: 99%

Normovolemic Hemodilution Prior to Cardiopulmonary Bypass: An Approach to Autologus Blood Transfusion Reduces Post Operative Homologous Blood Requirement

Nandy¹

2017

JMSCR

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“…Due to escaping crystalloid fluids into the interstitial space after 30 to 40 minutes, the volume for replacing should be three times the volume removed, i.e. for each 1 ml of blood removed; 3 ml of crystalloid solution should be infused [23]. Lactated Ringer solution is preferably because it has a lower incidence of acidosis, (a larger charge of chlorine in the saline solution tends to cause hyperchloremic metabolic acidosis) [24,25].…”

Section: Volemic Replacementmentioning

confidence: 99%

“…Lactated Ringer solution is preferably because it has a lower incidence of acidosis, (a larger charge of chlorine in the saline solution tends to cause hyperchloremic metabolic acidosis) [24,25]. Glucose solution should not be used due to its low plasmatic expansion properties and to its ability to cause cellular edema and hyperglycemia [23].…”

Section: Volemic Replacementmentioning

confidence: 99%

Acute Normovolemic Hemodilution: A Practical Approach

Araújo¹,

Garcia²

2013

OJAnes

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Justifications: Perioperative allogeneic blood transfusion can be reduced or even completely avoided by using a set of different strategies: meticulous hemostasis, the use of pharmaceutical agents that assist in the process of coagulation/ fibrinolysis, the use of blood substitutes, induced hypotension, preoperative autologous blood donation, collection and reinfusion of autologous blood during the operation, as well as from acute normovolemic hemodilution (ANH). Contents: ANH consists of taking a percentage of the patient's blood volume and a concurrent infusion of acellular fluids in order to maintain normovolemia. As a consequence, a hemodiluted patient will lose less blood cells for each blood volume that is lost during the surgical procedure. The aim of this study is to clarify doubts and provide practical information relative to the procedure of ANH through the author's own experiences as well as literary examples. Conclusions: ANH is an easy and cheap technique performed during the intraoperative period useful to reduce the use of hemoderivatives.

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Influence of crystalloid and colloid replacement solutions on hemodynamic variables during acute normovolemic hemodilution

Cited by 42 publications

References 19 publications

Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution

Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution

Normovolemic Hemodilution Prior to Cardiopulmonary Bypass: An Approach to Autologus Blood Transfusion Reduces Post Operative Homologous Blood Requirement

Acute Normovolemic Hemodilution: A Practical Approach

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Influence of crystalloid and colloid replacement solutions on hemodynamic variables during acute normovolemic hemodilution

Cited by 42 publications

References 19 publications

Acute decrease in renal microvascular Po2 during acute normovolemic hemodilution

Acute decrease in renal microvascular Po2 during acute normovolemic hemodilution

Normovolemic Hemodilution Prior to Cardiopulmonary Bypass: An Approach to Autologus Blood Transfusion Reduces Post Operative Homologous Blood Requirement

Acute Normovolemic Hemodilution: A Practical Approach

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Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution

Acute decrease in renal microvascular Po₂ during acute normovolemic hemodilution