كاربرد رقيق سازي حاد خون ثابت در جراحي قلب باز

Use of acute normovolemic hemodilution in cardiac surgery

Introduction: Blood transfusion is a necessary component of cardiac surgery with cardiopulmonary bypass because of severe bleeding and coagulopathies. On the other hand, today, there is a great interest in reducing blood transfusion with different methods. One of which is acute normovolemic hemodilution, a way of autologous transfusions. In this study, reduction of transfusion of allogenic blood has been investigated. Material and methods: This clinical- trail study was performed in Ghaem Hospital of Mashhad in 1382. 100 patients undergoing different cardiac surgery with cardiopulmonary bypass and hematocrit were investigated (a above 40%) The patients were divided into two groups of case and control randomely. They were all anesthetized with high-dose fentanyl method. In ANH group, the volume of blood withdrawn preoperatively was equal to the estimated blood volume (EBV) multiplied by the patients initial Hct (Hct0) minus the minimum allowable Hct (Hctf), divided by the average Hct (Hctav). As the blood was withdrawing, crystalloid solutions were administered approximately three times of blood volume removed. The withdrawn blood was transfused immediately after operation in ICU. Results: Hct decreased from 46.2 to 35.7 in case group and from 43.4 to 34.1 in control group 72 hours postoperative. The reduction of Hct after 72 hours, did not differ significantly between ANH and bontrol group (P=0.475) But the units of blood transfused, reduced remarkably in ANH group. Conclusion: We concluded that ANH is an effective method of reducing blood transfusion in cardiac surgery and we recommend its performance in all the patients undergoing cardiac surgery.