Acute limited normovolemic hemodilution can be safely used in a malnourished model.
This study investigates the effects of acute limited normovolemic hemodilution (ALNH) on intestinal healing in a malnourished animal model. Twenty rabbits were randomized into three Groups: Group 1 = control; Group 2 = ALNH (removal 35% blood volume and maintenance of normovolemia with 3:1 crystalloid infusion) followed by retransfusion (RT) after small bowel anastomosis (ANA). Group 3 had a restricted diet for 3 weeks preoperatively to cause a 15 percent to 20 percent weight loss. A six cm segment of small bowel (SB) was resected and anastomosed (ANA) in all animals. Blood pressure (BP), transserosal oxygen tension (TsPao2), hematocrit (Hct), colloid oncotic pressure (COP), wet-to-dry weight ratios (WW/DW), hydroxyproline (OH-Pro) content, and tensile strength (TS) of the ANA and a segment of adjacent SB were determined. BP did not change from baseline (BL) in Group 2 during ALNH; however, it rose significantly after RT (P less than 0.05). BP decreased significantly during ALNH in Group 3 (P less than 0.05) and did not rise above baseline after RT. There was no significant change in TsPao2 from BL within groups during the experiment. The Hct and COP decreased significantly after ALNH in Groups 2 and 3 after ALNH compared to BL (P less than 0.05). After RT the Hct and COP increased and by Day 8 the Hct had risen to BL values in Group 3 but not in Group 2 (P less than 0.05), whereas COP values were not significantly different from BL in either group. There was no difference in WW/DW or TS between or among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Woloszyn
T T
TT
Department of Surgery, Maimonides Medical Center, Brooklyn, New York.
Coons
M S
MS
Rodriguez
C
C
Levy
R
R
Heaney
M
M
Wang
S
S
Marini
C P
CP
D000714:Anastomosis, Surgical; D000818:Animals; D001810:Blood Volume; D004195:Disease Models, Animal; D006438:Hemodilution / Q000379:methods*; D007421:Intestine, Small / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D011502:Protein-Energy Malnutrition / Q000503:physiopathology / Q000628:therapy*; D011817:Rabbits; D014945:Wound Healing