[Efficacy and tolerance of Elohes 6% during peroperative normovolemic dilution].
This study assessed the cardiovascular stability of intraoperative normovolaemic haemodilution carried out with 6% Elohes during the exchange, the intraoperative, recovery and postoperative periods, as well as its effects on coagulation and renal function. Ten patients, ranked ASA 1, were included. Patients were premedicated with 100 mg of hydroxyzine, and anaesthesia was induced with 2 mg.kg-1 propofol, 3 micrograms.kg-1 fentanyl, and 0.5 mg.kg-1 atracurium. Maintenance was obtained with propofol, fentanyl and 50% nitrous oxide in oxygen. Haemodilution, carried out with a peripheral venous catheter, size 14 G, consisted in the removal of 15 ml.kg-1 of blood and its simultaneous replacement with Elohes 6%. Heart rate, systolic, diastolic and mean blood pressures were recorded before anaesthetic induction, every 5 min during the haemodilution, and thereafter during surgery, recovery and postoperative periods, up to the third postoperative day. Blood haemoglobin, fibrinogen, prothrombin, sodium, potassium, urea and creatinine concentrations, haematocrit, platelet count, and bleeding and activated cephalin times were assessed before and immediately after haemodilution, and on postoperative days 1 and 3. A mean of 1,295 +/- 68 ml of blood were removed during a 32 +/- 2 min period, and replaced by 1,315 +/- 64 ml of Elohes. Haematocrit decreased from 44 +/- 1.1% to 29.7 +/- 0.8%. There were no significant alterations in other parameters, except for an increase in heart rate at the time of extubation. Cardiovascular parameters, as well as the haemodilution, were stable up to the end of the study period. It is concluded that replacing blood with Elohes for intentional haemodilution affords convenient cardiovascular stability.(ABSTRACT TRUNCATED AT 250 WORDS)
Besnard
M
M
Département d'Anesthésie-Réanimation, CHU, Caen.
Fauchon
G
G
Thomassin
C
C
Gérard
J L
JL
Locker
B
B
Bricard
H
H
D000328:Adult; D001780:Blood Coagulation Tests; D001794:Blood Pressure / Q000187:drug effects; D001798:Blood Proteins / Q000032:analysis; D004361:Drug Tolerance; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D010976:Platelet Count; D011108:Polymers / Q000494:pharmacology / Q000627:therapeutic use*; D013213:Starch / Q000494:pharmacology / Q000627:therapeutic use*
D001798:Blood Proteins; D011108:Polymers; C062890:polystarch; D013213:Starch
Efficacité et tolérance de l'Elohes 6% au cours de l'hémodilution normovolémique peropératoire.