Hemodilution in complicated high velocity vascular injuries of limbs

J Cardiovasc Surg (Torino). 1996 Jun;37(3):217-21.

Abstract

Normovolemic hemodilution with 3,5% polygeline was carried out in fourteen ASA (American Society of Anesthesiologists) Class-I patients, who had developed false aneurysms or arteriovenous fistulas following high velocity injury on limbs. At the end of surgical procedure volume of mean blood drained was 1400.00 +/- 194.46 ml, mean surgical blood loss was 1665.71 (+/- 33.9) ml and fluid balance was 557.14 (+/- 176.40) ml. Arteriovenous oxygen content difference (C(a-v) O2), central venous pressure (CVP), heart rate and mean arterial pressure (MAP) did not show any significant variation from pre-hemorrhage value. Hematocrit (Hct%) and hemoglobin (Hb gm%) showed a highly significant fall following hemodilution and retransfusion. However on the day of discharge Hct% (37.5(+/- 3.88) and Hb gm% (12.84 (+/- 0.82) had increased from post hemodilution value of 28.96 (+/- 1.98) and 10.04 (+/- 0.87) respectively. 71% patients did not need any homologous blood transfusion. Prothrombin time index (PTI%) showed 7.5% fall at the conclusion of blood retransfusion and 3.94% fall on the day of discharge. Technique is safe, avoids use of homologous blood and is thus recommended during surgical correction of complicated high velocity vascular injury of limbs.

MeSH terms

  • Adult
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Aneurysm, False / therapy
  • Arm Injuries / etiology
  • Arm Injuries / surgery
  • Arm Injuries / therapy
  • Arteriovenous Fistula / etiology
  • Arteriovenous Fistula / surgery*
  • Arteriovenous Fistula / therapy
  • Blood Loss, Surgical
  • Blood Transfusion
  • Blood Vessels / injuries*
  • Hemodilution*
  • Humans
  • Leg Injuries / etiology
  • Leg Injuries / surgery
  • Leg Injuries / therapy
  • Wounds, Gunshot / surgery*
  • Wounds, Gunshot / therapy