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[Value of hemodilution in the prevention of post-operative thromboses]
The principal consequence of normovolaemic haemodilution is an increase in the venous return. We have studied the effects of two different levels of pre-operative haemodilution on the incidence of post-operative thromboembolic complications in 5 004 patients. We monitored pulse, arterial pressure, central venous pressure and diuresis. Losses of blood, water and electrolytes were made up by perfusions of Ringerlactate or solution of balanced Gelatin Fluid. Where significant haemorrhage occurred, these solutions were used alternately with transfusions. According to the level of the haematocrit on the day following operation, the patients undergoing major surgery (1 388 cases) were divided into 3 groups. Group A (307 cases) had a haematocrit less than or equal to 32 %, Group B (497 cases) had a haematocrit between 32 and 38 %, and Group C (control) (584 cases) had a haematocrit greater than or equal to 38 %. The percentages of complications in each group were as follows : Group A = 0 % - Group B = 0.2 % - Group C = 1.8 %. Our favourable clinical impression in regard to Group B was confirmed by a double blind study carried out with the clinicians concerned. We could not find any complication referable to the use of this method.
The principal consequence of normovolaemic haemodilution is an increase in the venous return. We have studied the effects of two different levels of pre-operative haemodilution on the incidence of post-operative thromboembolic complications in 5 004 patients. We monitored pulse, arterial pressure, central venous pressure and diuresis. Losses of blood, water and electrolytes were made up by perfusions of Ringerlactate or solution of balanced Gelatin Fluid. Where significant haemorrhage occurred, these solutions were used alternately with transfusions. According to the level of the haematocrit on the day following operation, the patients undergoing major surgery (1 388 cases) were divided into 3 groups. Group A (307 cases) had a haematocrit less than or equal to 32 %, Group B (497 cases) had a haematocrit between 32 and 38 %, and Group C (control) (584 cases) had a haematocrit greater than or equal to 38 %. The percentages of complications in each group were as follows : Group A = 0 % - Group B = 0.2 % - Group C = 1.8 %. Our favourable clinical impression in regard to Group B was confirmed by a double blind study carried out with the clinicians concerned. We could not find any complication referable to the use of this method.