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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2011;6(1):50-53.
Published online January 31, 2011.
The hemodynamic responses and adequacy of infusion volume in acute hypervolemic hemodilution assessed with transesophageal Doppler apparatus
Ji Young Lee, Sung Jin Hong, Mee Young Chung
Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Acute hypervolemic hemodilution (AHH), an alternative of acute normovolemic hemodilution (ANH) is simpler, less expensive and less time-consuming than ANH. We examined hemodynamic responses and adequacy of 15 ml/kg infusion volume with transesophageal Doppler apparatus.
We induced AHH in 26 patients undergoing major abdominal surgery by fluid administration with volume of 15 ml/kg. During AHH, we observed hemodynamic parameters of cardiac index (CI), stroke index (SI), left ventricular ejection time corrected (LVETc), acceleration (Acc), peak velocity (PV), total systemic vascular resistance (TSVR) by transesophageal Doppler device and measured central venous pressure (CVP) via subclavian catheter every 2 minutes (H0, H2, H4, H6, H8, H10).
After AHH, hemoglobin and arterial oxygen content value were decreased about 14% and tolerable. During AHH, CVP and SI increased first from H2. CI and LVETc, representing blood flow like SI increased from H4. TSVR decreased from H4, but Acc and PV representing cardiac contractility did not change through the AHH. Through AHH by infusion volume of 15 ml/kg, hemodynamic changes were tolerable.
AHH increased aortic blood flow, decreased afterload, but did not affect cardiac contractility at all. The volume of 15 ml/kg for AHH is acceptable in clinical situation.
Key Words: Hypervolemic hemodilution, Transesophageal Doppler
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