Acute normovolemic hemodilution combined with controlled low central venous pressure on coagulation function and blood loss in patients undergoing hepatic resection

Objective To investigate effect of acute normovolemic hemodilution(ANH) combined with controlled low central venous pressure(LCVP) on coagulation function and blood loss in patients undergoing hepatic resection.Methods Sixty ASAⅠorⅡ patients,aged 35~71yr,body mass index(18~28)kg/m2,scheduled for hepatic resection,were randomly divided into 3 groups(n=20 each):control group(group Ⅰ),LCVP group(group Ⅱ) and ANH combined with LCVP group(group Ⅲ).Group Ⅰreceived no ANH and LCVP.In group Ⅱ,CVP was maintained at 2~5 cmH2O until hepatic parenchymal transaction.In group Ⅲ,ANH was used after intubation,the other dealing was given the same as the group Ⅱ.The blood samples were taken from internal jugular vein for determination of the index of blood coagulation function,such as prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and plasma fibrinogen concentration(FIB) before anesthesia(T0),30 min(T1),60 min(T2) after hemodilution and at the end of surgery(T3).Intraoperative blood loss and blood transfusion were measured.Results Intraoperative blood loss,blood transfusion and the number of blood transfusion were greater in group Ⅰthan in the other groups.Blood transfusion and the number of blood transfusion were less in group Ⅲ than in groupⅡ(P0.05).All the parameters of coagulation function in the three groups were in the normal ranges.Conclusion Moderate ANH combined with LCVP can decrease intraoperative blood loss but does not affect coagulation function in patients undergoing hepatic resection.