Effects of Sodium Nitroprusside-induced Hypotension under Acute Normovolemic Hemodilution on the Cardiovascular System and Systemic Oxygen Balance in Dogs / 대한마취과학회지

ABSTRACT

BACKGROUND: To decrease homologuous transfusion and bleeding, Acute Normovolemic Hemodilution (ANH) may be combined with induced hypotension. Tissue oxygen balance may be in danger because of decreased tissue perfusion pressure by induced hypotension and reduced arterial oxygen content by ANH. Thus it is necessary to evaluate effects of induced hypotension combined with ANH on hemodynamics and systemic oxygen balance. METHODS: In 6 mongrel dogs anesthetized with N2O-O2-enflurane and paralyzed with vecuronium, ANH was performed up to half of initial level of hemoglobin with isovolemic pentastarch infusion, and then mean arterial pressure (MAP) was lowered by 30% of the initial value by intravenous administration of Sodium Nitroprusside (SNP). Various hemodynamic parameters were measured before and after ANH and 15, 30, 45 and 60 minutes after induction of hypotension and 15 minutes after the end of hypotension. RESULTS: Heart rate was not changed significantly throughout the study. Central venous pressure increased significantly after ANH but decreased to the initial value after induced hypotension. Systemic vascular resistance showed significant decrease after ANH, more significant decrease after induced hypotension and slight increase after discontinuation of SNP. Cardiac output increased markedly by ANH and maintained during induced hypotension. Oxygen flux decreased significantly after ANH but slightly increased after induced hypotension. Oxygen consumption and Oxygen extraction ratio were maintained throughout the study. There were no acidemia and hypoxemia throughout the study. CONCLUSION: The combined use of ANH and induced hypotension with SNP is safe in the aspect of cardiovascular system and systemic oxygen balance.