Effect of hemodilution on tissue perfusion and blood coagulation during radical hysterectomy.
OBJECTIVE
The goal of this study was to evaluate the safety of hemodilution on global and splanchnic perfusion and blood coagulation during radical hysterectomy.


METHODS
A pulmonary artery catheter and a gastric tonometry catheter were placed in 16 patients with cervical carcinoma. Global perfusion indices, splanchnic perfusion index, and coagulation tests were obtained. Blood was removed to achieve a hemoglobin measurement of 8-9 9 g/dL. Three more measurements were repeated after hemodilution, at the end of surgery, and after the retransfusion of blood. Analysis of variance was used to determine statistical significance.


RESULTS
Sixteen patients with cervical carcinoma had 1.0 +/- 0.3 L (mean +/- SD) of blood removed and had a blood loss of 0.8 +/- 0.7 L. Hemodiluted preoperative hemoglobin was 8.7 +/- 1 g/dL. All of the global perfusion indices, except for arterial pH and oxygen consumption, decreased after hemodilution and recovered with the retransfusion of blood (P < or = 0.004). Splanchnic perfusion and coagulation tests were unchanged (P > or = 0.1). Major complication was pulmonary edema in one patient.


CONCLUSIONS
Hemodilution during radical hysterectomy, in this select group of patients, does not appear to compromise tissue perfusion or coagulation.
Santoso
J T
JT
Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas 77555, USA. santoso@1331union.com
Hannigan
E V
EV
Levine
L
L
Solanki
D R
DR
Mathru
M
M
D000328:Adult; D001777:Blood Coagulation / Q000502:physiology*; D001804:Blood Transfusion, Autologous; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005753:Gastric Mucosa / Q000378:metabolism; D006438:Hemodilution / Q000009:adverse effects / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D013152:Splanchnic Circulation / Q000502:physiology*; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000601:surgery*
D006454:Hemoglobins; D005340:Fibrinogen