Effect of preoperative acute hypervolemic hemodilution on renal function of elderly patients undergoing thoracotomy

Aim: To observe the effect of mild-degree preoperative acute hypervolemic hemodilution(AHH) on renal function of elderly patients undergoing thoracotomy. Methods:Thirty-six elderly patients were randomly equally divided into three groups. Patients in Group A, B, C were infused 15 ml·kg-1 of Voluven, HES and sodium Lactate intravenously, respectively. All of AHH were started at the time of 15 min before anesthesia induction and practiced at a rate of 20～35 ml·min-1 and achieved within 30 min. Heart rate, electrocardiogram, nontraumatic arterial pressure, mean arterial pressure and degree of blood oxygen saturation were monitored continually during the whole operation. Venous and urine before AHH, after AHH, 30 min, 60 min, 3 h after AHH were collected for determining the blood urea nitrogen(BUN), creatinine(Cr), urinary α1-microglobulin(α1-MG). Results: There were no significant differences in BUN and Cr among the three groups at all time points (P0.05). There were no significant differences in α1-MG among the three groups (P0.05), but the α1-MG level of the three groups 3 h after AHH, were significantly higher than those at other time points (P0.05). Conclusion: Mild-degree AHH with Voluven or HES have no obvious harmful effect on renal function of the elderly patients.