Effects of acute hypervolemic hemodilution with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation / 中国医师进修杂志

ABSTRACT

Objective To study the effects of acute hypervolemic hemodilution (AHH) with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation. Methods Thirty patients scheduled for spinal operation were randomly divided into AHH group and control group with 15 cases each. Patients in AHH group were performed AHH by transfusing hydroxyethly starch 130/0.4 (15 ml/kg) with 25 ml/min before skin incision, to achieve expansion of 20% to 30%. Patients in control group were transfused routinely. Blood samples were taken from internal jugular vein before anesthesia induction (T0), at 1 h after anesthesia induction (T1) and termination of operation (T2) for determination of hemoglobin (Hb), hematocrit (Hct), platelet (Plt), prothrombin time(PT), partial thromboplastin time ( APTT), thrombin time( TT) and fibrinogen( FIB), at the same time heart rate( HR), mean arterial pressure (MAP) and central venous pressure (CVP) were observed and recorded. Results HR and MAP in both groups had no statistical difference within or between groups (P > 0.05). CVP at T1 and T2 in AHH group [(11.8 ± 1.0,(11.3 ± 1.0) cm H2O (1 cm H2O = 0.098 kPa)]were higher than that at T0 [(6.3 ±0.7) cm H2O]and that in control group ( P < 0.05). Hb and Hct at T1 and T2 in AHH group were lower than that at T0 and that in control group (P< 0.05). Plt and FIB at T1 and T2 in AHH group decreased significantly than that at T0(P<0.05), while there were no statistical difference between two groups(P> 0.05). PT, TT and APTT in both groups had no statistical difference within or between groups (P > 0.05). Conclusion AHH with hydroxyethly starch 130/0.4 has no significant effect on function of blood clotting in patients undergoing spinal operation.