Hemodilution in complicated high velocity vascular injuries of limbs.
Normovolemic hemodilution with 3,5% polygeline was carried out in fourteen ASA (American Society of Anesthesiologists) Class-I patients, who had developed false aneurysms or arteriovenous fistulas following high velocity injury on limbs. At the end of surgical procedure volume of mean blood drained was 1400.00 +/- 194.46 ml, mean surgical blood loss was 1665.71 (+/- 33.9) ml and fluid balance was 557.14 (+/- 176.40) ml. Arteriovenous oxygen content difference (C(a-v) O2), central venous pressure (CVP), heart rate and mean arterial pressure (MAP) did not show any significant variation from pre-hemorrhage value. Hematocrit (Hct%) and hemoglobin (Hb gm%) showed a highly significant fall following hemodilution and retransfusion. However on the day of discharge Hct% (37.5(+/- 3.88) and Hb gm% (12.84 (+/- 0.82) had increased from post hemodilution value of 28.96 (+/- 1.98) and 10.04 (+/- 0.87) respectively. 71% patients did not need any homologous blood transfusion. Prothrombin time index (PTI%) showed 7.5% fall at the conclusion of blood retransfusion and 3.94% fall on the day of discharge. Technique is safe, avoids use of homologous blood and is thus recommended during surgical correction of complicated high velocity vascular injury of limbs.
Mackay
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Department of Anaesthesiology and Critical Care Medicine, Institute of Medical Sciences, Soura, Srinagar-Kashmir, India.
Shugufta
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Din
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Guru
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D000328:Adult; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D001134:Arm Injuries / Q000209:etiology / Q000601:surgery / Q000628:therapy; D001164:Arteriovenous Fistula / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001808:Blood Vessels / Q000293:injuries*; D006438:Hemodilution; D006801:Humans; D007869:Leg Injuries / Q000209:etiology / Q000601:surgery / Q000628:therapy; D014948:Wounds, Gunshot / Q000601:surgery* / Q000628:therapy