Use of sufficient hemodilution to prevent coagulopathies following surgical correction of cyanotic heart disease.
During surgical correction of cyanotic heart disease with associated polycythemia, sufficient reduction of hemoglobin and hematocrit values has proved effective in preventing postoperative coagulopathies. Three groups of surgical patients were studied: Group I--a control group consisting of 75 adults undergoing uncomplicated correction of acquired heart disease and requiring no blood or blood component transfusion; Group II--15 patients with tetralogy of Fallot whose intraoperative hemoglobin values remained above 10 gm/dl with conventional hemodilution techniques; and Group III--21 cyanotic surgical patients whose intraoperative hemoglobin values were lowered to less than 10 gm/dl with sufficient hemodilution. Group III was further broken down into a subgroup of six patients (Group IIIa) who underwent sequential laboratory determinations, as in Group I. In Group IIIa, postoperative coagulation function tests were only slightly more abnormal than in the nonpolycythemic control group (Group I). Patients in Group III (who had ample hemodilution) experienced 45% less bleeding and required 54% fewer blood components than those in Group II (who underwent conventional hemodilution).
D000293:Adolescent; D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D001780:Blood Coagulation Tests; D002315:Cardiopulmonary Bypass; D002648:Child; D000077324:Crystalloid Solutions; D006330:Heart Defects, Congenital / Q000097:blood / Q000150:complications / Q000601:surgery*; D006438:Hemodilution; D006801:Humans; D007552:Isotonic Solutions; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011086:Polycythemia / Q000150:complications; D011183:Postoperative Complications
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes