Skip to main content
SpringerLink
Log in

Safe Limits of Hemodilution in Patients with Coronary Artery Disease

  • Chapter
Der kardiale Risikopatient in der operativen Medizin

  • 16 Accesses

Abstract

Intentional hemodilution has been introduced into surgery because transfusions using donor blood are associated with significant risks. The appearance of acquired immunodeficiency syndrome (AIDS) and its possible transmission via transfusion, despite donor selection, is a very sensitive problem for patients and physicians [1]. However, AIDS ist probably not the major problem, since the risk of non-A non-B hepatitis transmission is quantitatively more important. In addition, the evidence that transfusion of homologous blood can induce immunosuppression and thereby impair the host resistance of surgical patients is a new cause of concern [12]. These problems with homologous transfusion have promoted the use of all techniques of autotransfusion. Among these, intentional hemodilution is the one which has probably enjoyed the greatest development, since it is the simplest and least expensive.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bove JR (1984) Transfusion associated AIDS–a cause for concern. N Engl J Med 310: 115–116

    Article  PubMed  CAS  Google Scholar 

  2. Brazier J, Cooper N, Maloney JV, Buckberg C (1974) The adequacy of myocardial oxygen delivery in acute normovolemic anemia. Surgery 75: 508–516

    PubMed  CAS  Google Scholar 

  3. Carey JS (1975) Determinants of cardiac output during experimental therapeutic hemodilution. Ann Surg 18: 196–202

    Article  Google Scholar 

  4. Davies MJ, Cronin KD, Domaingue C (1982) Haemodilution for major vascular surgery using 3, 5% polygeline ( Haemaccel ). Anaesth Intensive care 10: 265–270

    PubMed  CAS  Google Scholar 

  5. Geha AS (1976) Coronary and cardiovascular dynamics and oxygen availability during acute normovolemic anemia. Surgery 80: 47–53

    PubMed  CAS  Google Scholar 

  6. Gisselsson L, Rosberg B, Ericsson M (1982) Myocardial blood flow, oxygen uptake and carbon dioxide release of the human heart during hemodilution. Acta Anaesthesiol Scand 26: 589–591

    Article  PubMed  CAS  Google Scholar 

  7. Glick G, Plauth WH, Braunwald E (1964) Role of the autonomic nervous system in the circulatory response to acutely induced anemia in anesthetized dogs. J Clin Invest 43: 2112–2124

    Article  PubMed  CAS  Google Scholar 

  8. Guyton AC, Richardson TQ (1961) Effect of hematocrit on venous return. Circ Res 9: 157–161

    PubMed  CAS  Google Scholar 

  9. Hagl S, Heimlich W, Meisner H, Erben R, Baum M, Mendier N (1977) The effect of hemodilution of regional function in the presence of coronary stenosis. Basis Res Cardiol 72: 344–364

    Article  CAS  Google Scholar 

  10. Hatcher JD; Chiu KL, Jennings DB (1978) Anemia as a stimulus to aortic and carotid chemoreceptors in the cat. J Appl Physiol 44: 696–702

    PubMed  CAS  Google Scholar 

  11. Hint H (1968) The pharmacology of dextran and physiological background of the clincal use of Rheomacrodex. Acta Anaesthesiol Belg 19: 119–138

    PubMed  CAS  Google Scholar 

  12. Horsey PF (1989) Blood transfusion and surgery. Br Med J 291: 291–234

    Google Scholar 

  13. Jan KM, Chien S (1977) Effect of hematocrit variations on coronary hemodynamics and oxygen utilisation. Am J Physiol 233: H106 - H113

    PubMed  CAS  Google Scholar 

  14. Laks H, Pilon RN, Klovekorn WP, Anderson W, McCallum JR, O’Connor NE (1974) Acute hemodilution: its effect on hemodynamics and oxygen transport in anesthetized man. Ann Surg 180: 103–109

    Article  PubMed  CAS  Google Scholar 

  15. Laxenaire MC, Aug F, Voisin C, Chevreaud C, Bauer P, Bertrand A (1986) Effects of haemodilution on ventricular function in coronary heart disease patients: Ann Fr Anesth Reanim 5: 218–222

    PubMed  CAS  Google Scholar 

  16. Leone BJ, Saphn DR, McRae RL, Smith LR (1990) Effects of hemodilution on regional function of compromised myocardium. Anesthesiology [Suppl] 73: A596

    Google Scholar 

  17. Linden P van der, Baron JF, Philipp I et al. (1987) Normovolemic hemodilution in anesthetized patients with coronary artery disease: effects on hemodynamic and left ventricular function. Anesthesiology [Suppl] 67: A135

    Article  Google Scholar 

  18. Linden P van der, Baron JF, Philipp I et al. (1987) Normovolemic hemodilution in anesthetized patients with coronary artery disease: hemodynamic and metabolic responses to recovery. Anesthesiology [Suppl] 67: A79

    Article  Google Scholar 

  19. Messmer K, Sunder-Plassmann L, Jesch F, Gormandt L, Sinagowitz E, Kessler M (1973) Oxygen supply to the tissues during normovolemic hemodilution. Respir Exp Med 159: 152–166

    Article  CAS  Google Scholar 

  20. Messmer K, Kreimeier U, Intaglietta M (1986) Present state of intentional hemodilution. Eur Surg Res 18: 254–263

    Article  PubMed  CAS  Google Scholar 

  21. Niinikoski J, Lassksonen V, Meretoja O, Jalonen J, Inberg MV (1981) Oxygen transport to tissue under normovolemic moderate and extreme hemodilution during coronary bypass operation. Ann Thorac Surg 31: 134–143

    Article  PubMed  CAS  Google Scholar 

  22. Race D, Dedichen H, Schenk WG (1967) Regional blood flow during dextran-induced normovolemic hemodilution in the dog. J Thorac Cardiovasc Surg 53: 578–586

    PubMed  CAS  Google Scholar 

  23. Rodriguez JA, Chamorro GA, Rapaport E (1974) Effect of isovolumic anemia on ventricular performance at rest and during exercise. J Appl Physiol 36: 28–33

    PubMed  CAS  Google Scholar 

  24. Rose D, Coussofides T (1981) Intraoperative normovolemic hemodilution. J Surg Res 31: 375–381

    Article  PubMed  CAS  Google Scholar 

  25. Shah DM, Prichard MN, Newell JC, Karmody AM, Scovill WA, Powers SR (1980) Increased cardiac output and oxygen transport after intraoperative isovolumic hemodilution. A study in patients with peripheral vascular disease. Arch Surg 115: 597–600

    PubMed  CAS  Google Scholar 

  26. Stucker O, Trouve R, Vicaut E et al. (1983) Effects of different hematocrits on the isolated working rabbit heart perfused after ischemia. Int J Microcirc Clin Exp 2: 325–335

    PubMed  CAS  Google Scholar 

  27. Sunder-Plassmann L, Klovekorn WP, Holper K, Hase U, Messmer K (1971) The physiological significance of acutely induced hemodilution. In: Ditzel J, Lewis DH (eds) 6th European Conference on Microcirculation. Karger, Basel, pp 23–28

    Google Scholar 

  28. Vicaut E, Stucker O, Teisseire B, Duvelleroy M (1987) Changes in systemic hematocrit and red cell fluxes at capillary bifurcations in rat cremaster muscles. Int J Microcirc Clin Exp 6: 225–235

    PubMed  CAS  Google Scholar 

  29. Yoshikawa H, Powell J, Bland JHL, Lowenstein E (1973) Effects of acute anemia on experimental myocardial ischemia. Am J Cardiol 32: 670–678

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. J. F. Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Moutafis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Viars
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Abteilung Medizin, Deutsche Abbott GmbH, Max-Planck-Ring 2, W-6200, Delkenheim, Wiesbaden, Deutschland

    Jonny Hobbhahn

  2. Institut für Anästhesiologie, Ludwig-Maximilians-Universität München Klinikum Großhadern, Marchioninistraße 15, W-8000, München 70, Deutschland

    Peter Conzen  & Klaus Peter  & 

  3. Institut für Anästhesiologie, Universität Regensburg, Universitätsstraße 31, W-8400, Regensburg, Deutschland

    Kai Taeger

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Baron, J.F., Moutafis, M., Viars, P. (1992). Safe Limits of Hemodilution in Patients with Coronary Artery Disease. In: Hobbhahn, J., Conzen, P., Peter, K., Taeger, K. (eds) Der kardiale Risikopatient in der operativen Medizin. Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine, vol 222. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77007-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-77007-4_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-54647-4

  • Online ISBN: 978-3-642-77007-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation