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From low hematocrit physiology to isovolemic hemodilution
1Anaesthesia and Intensive Care Unit, Galeazzi Orthopaedic Institute, Milano, Italy.
The International Journal of Artificial Organs
|March 1, 1995
Summary
This study explores intentional anemia, specifically normovolemic hemodilution, to improve surgical outcomes. The findings support its wider use, highlighting safety and benefits in high-risk procedures like orthopedic surgery.
Area of Science:
- Physiology
- Anesthesiology
- Surgical Techniques
Background:
- Physiology demonstrates a linear relationship between hematocrit and blood fluidity.
- Blood viscosity and aggregability are critical factors in circulation and thromboembolic complications.
- Maintaining a low hematocrit relative to volemia is crucial for surgical procedures, especially high-embolism risk surgeries.
Purpose of the Study:
- To address the increasing use of intentional anemia.
- To analyze the risks and physiological impacts of normovolemic hemodilution.
- To propose a safe protocol for intentional normovolemic hemodilution.
Main Methods:
- Analysis of physiological principles linking hematocrit, blood fluidity, and viscosity.
- Evaluation of risks and organ-specific changes associated with normovolemic hemodilution.
- Development of a perioperative schedule (preoperative, intraoperative, postoperative) based on anesthesiology experience.
Main Results:
- Normovolemic hemodilution was analyzed for its associated risks and physiological effects.
- A practical operating schedule for safe intentional normovolemic hemodilution was proposed.
- The technique's safety concerning volemia was confirmed.
Conclusions:
- Intentional normovolemic hemodilution is a valuable technique in surgery.
- The proposed protocol ensures safety across preoperative, intraoperative, and postoperative phases.
- Wider adoption of normovolemic hemodilution is advocated for improved surgical outcomes.