Asymptomatic carotid disorder and hemodilution: a perioperative study in major orthopaedic surgery

The aim of this study was to assess the pattern of adaptation to severe Haemodilution in pts with normal or stenotic carotid vessels. We enrolled 180 consecutive pts undergoing total hip replacement: 138 pts had echo-Doppler documented normal carotid arteries, 10 pts had kinking and 32 pts had monolateral or bilateral stenosis of internal carotid arteries (lesions, class of stenosis 1-49%). Haemoglobin values on the 4th day after surgery was 8.7 +/- 1.2 g/dl with no statistically significant differences in pts (patients) with carotid disorders versus normal pts. No pt showed clinical signs of cerebral ischemia or brain damage in the postoperative period. These results are consistent with experimental and clinical data showing that normovolaemic anaemia is well tolerated without disabling symptoms in pts with mild or moderate stenosis of carotid arteries.