Effects of acute normovolemic hemodilution on hemodynamics and oxygen supply in adult patients undergoing correction of tetralogy of Fallot

Abstract

Objective To evaluate the effects of acute normovolemic hemodilution (ANH) on hemodynamics and oxygen supply in adult patients undergoing correction of tetralogy of Fallot. Methods Ten consecutive patients, aged 20-59 yr, weighing 41-61 kg, of American Society of Anesthesiologists physical status Ⅲ-Ⅳ, scheduled for elective correction of tetralogy of Fallot, were enrolled in the study.After induction of anesthesia, ANH was performed when hemodynamics was stable and stroke volume variation (SVV) ≤10%.Blood was withdrawn from the femoral artery, the blood collected was expected to be 15% of blood volume, and the shed blood was reinfused after the end of cardiopulmonary bypass.The blood loss was simultaneously replaced with the equal volume of 6% hydroxyethyl starch.Heart rate, mean arterial pressure, central venous pressure, cardiac output, SVV and peripheral vascular resistance were recorded before ANH and at 5 min after the end of ANH.Blood samples were collected for determination of hemoglobin and blood gas analysis, arterial oxygen saturation, arterial oxygen partial pressure and lactate concentrations were recorded, and oxygen supply was calculated. Results Compared with the baseline before ANH, cardiac output was significantly increased, and peripheral vascular resistance and hemoglobin were decreased after ANH (P 0.05). Conclusion ANH can increase cardiac output and maintain oxygen supply and hemodynamics stable when used for adult patients undergoing correction of tetralogy of Fallot. Key words: Hemodilution; Tetralogy of Fallot; Hemodynamics; Oxygen