The hemodynamic responses and adequacy of infusion volume in acute hypervolemic hemodilution assessed with transesophageal Doppler apparatus

Lee, Ji Young; Hong, Sung Jin; Chung, Mee Young

Abstract

BACKGROUND
Acute hypervolemic hemodilution (AHH), an alternative of acute normovolemic hemodilution (ANH) is simpler, less expensive and less time-consuming than ANH. We examined hemodynamic responses and adequacy of 15 ml/kg infusion volume with transesophageal Doppler apparatus.
METHODS
We induced AHH in 26 patients undergoing major abdominal surgery by fluid administration with volume of 15 ml/kg. During AHH, we observed hemodynamic parameters of cardiac index (CI), stroke index (SI), left ventricular ejection time corrected (LVETc), acceleration (Acc), peak velocity (PV), total systemic vascular resistance (TSVR) by transesophageal Doppler device and measured central venous pressure (CVP) via subclavian catheter every 2 minutes (H0, H2, H4, H6, H8, H10).
RESULTS
After AHH, hemoglobin and arterial oxygen content value were decreased about 14% and tolerable. During AHH, CVP and SI increased first from H2. CI and LVETc, representing blood flow like SI increased from H4. TSVR decreased from H4, but Acc and PV representing cardiac contractility did not change through the AHH. Through AHH by infusion volume of 15 ml/kg, hemodynamic changes were tolerable.
CONCLUSIONS
AHH increased aortic blood flow, decreased afterload, but did not affect cardiac contractility at all. The volume of 15 ml/kg for AHH is acceptable in clinical situation.