[Effect of hypervolemic hemodilution on C-reactive protein level in patients receiving spinal surgery]

To investigate the changes in high-sensitivity C-reactive protein (hs-CRP) levels following acute hypervolemic hemodilution (AHH) in patients undergoing spinal surgery and assess the safety of AHH in terms of postoperative infection.

Forty patients undergoing spinal operation were randomly assigned into observation group and control group (n=20). Each patient was infused 4 ml/kg/h lactated Ringers solution for maintenance of the total blood volume, and in the observation group, the patients received additional infusion of 4% gelofusine solution at the rate of 20 ml/kg/h 30 min before the operation. Venous blood samples were collected to monitor the hematocrit (Hct), prothrombin time (PT), activated partial thromboplastin time (APTT) and hs-CRP before anesthesia (T0), 2 h after the beginning of the operation (T1), at the end of the operation (T2), and 24 h after the operation (T3).

After AHH, Hct decreased significantly at T1 as compared with that at T0 (P<0.05) and that of the control group (P<0.01), but showed no significant difference between the two groups at T2. PT and APTT showed significant changes at T1 compared with T0 (P<0.05) but within the normal range, and were similar between the two groups at T3. hs-CRP increased significantly in the two groups at T3 compared with that at T0 (P<0.05), and a significant difference was noted between the two groups (P<0.01).

AHH does not affect the hemodynamics and blood coagulation of the patients undergoing spinal surgery but causes a significant elevation of hs-CRP, suggesting an increased risk of postoperative infection.