Influence of intraoperative autologous blood transfusion on oxygen metabolism in patient undergoing orthopedic surgery / 中华麻醉学杂志

ABSTRACT

Objective To investigate the influence of autologous blood transfusion on oxygen metabolism in patients undergoing orthopedics surgery. Methods Forty patients 28-65 yr weighing 55-80 kg scheduled for internal fixation of spine were randomly divided into two groups with 20 patients in each group. Anesthesia was induced with intravenous fentanyl , propofol and vecuronium and maintained with inhalation of isoflurane. Patients bleeding less than 600 ml or more than 1 200 ml were excluded. When the loss blood volume was more than 600 ml, the autologous blood of 600 ml obtained from the autotransfusion device was remfused to the patients in group A, the heterogenous blood of 600 ml was transfused in group B, The radial and pulmonary arteries were cannulated for measurement of hemodynamics and blood gas analysis. The cardiac index, oxygen delivery, oxygen consumption, oxygen extraction ratio were calculated and blood lactate concentration was measured immediately before anesthesia , after infusion of autologous or heterogenous blood, at the end of the operation and one day after the operation respectively. Results Compared with the baseline, only oxygen delivery increased significantly after infusion autologous blood or heterogenous blood, at the end of the operation in both groups ( P 0.05) . As compared with that in group B, oxygen extraction ratio decreased significantly in group A ( P 0.05). Conclusion Upon condition that bleeding volumes is limited (600-1 200 ml) in patient undergoing orthopedic surgery, autologous blood transfusion technique can provide enough oxygen for tissue metabolism.