Application of Acute Hypervolemic Hemodilution in Spinal Internal Fixation Surgery

[Objective] To observe the effectiveness and feasibility of Acute Hypervolemic Hemodilution(AHH)during the operation.[Methods] Twenty five ASAⅠ～Ⅱpatients scheduled for internal fixation surgery of thoracic/lumbar vertebrae under general anesthesia were divided into two groups :control group(groupⅠ)(n=12)and AHH(groupⅡ)(n=13).In group Ⅱ,patients were infused 6% HES(130/0.4,Voluven)in speed of 50 mL/min and with volume of 15 mL/kg after induction and before operation.AHH wasn't done in group Ⅰ.The hemodynamics,blood transfusion and blood loss of the two groups were compared.[Results] The intraoperative blood transfusion in group Ⅰand groupⅡ were(550±32)mL and(302±26)mL,respectively,and there were significant differences between them(P0.05).The intraoperative blood loss in group Ⅰand groupⅡ were(1058±330)mL and(1004±215)mL,respectively,and there were no significant differences between them(P0.05).Hematocrit(Hct)after AHH was more lower in group Ⅱ than that in groupⅠ,and there were significant changes between them(P0.05).There were no significant changes in two groups on heart rate(HR)and mean arterial pressure(MAP)at five time points in the study.Central venous pressure(CVP)was markedly increased after AHH in group Ⅱ,but all in normal.Differences on CVP didn't exist between two groups at T4.[Conclusion]AHH cannot decrease the intraoperative blood loss but can efficiently decrease the intraoperative blood transfusion.It can be safely used for major operation with fairly stable hemodynamics.