Hemodilution in complicated high velocity vascular injuries of limbs

Normovolemic hemodilution with 3,5% polygeline was carried out in fourteen ASA (American Society of Anesthesiologists) Class-I patients, who had developed false aneurysms or arteriovenous fistulas following high velocity injury on limbs. At the end of surgical procedure volume of mean blood drained was 1400.00 +/- 194.46 ml, mean surgical blood loss was 1665.71 (+/- 33.9) ml and fluid balance was 557.14 (+/- 176.40) ml. Arteriovenous oxygen content difference (C(a-v) O2), central venous pressure (CVP), heart rate and mean arterial pressure (MAP) did not show any significant variation from pre-hemorrhage value. Hematocrit (Hct%) and hemoglobin (Hb gm%) showed a highly significant fall following hemodilution and retransfusion. However on the day of discharge Hct% (37.5(+/- 3.88) and Hb gm% (12.84 (+/- 0.82) had increased from post hemodilution value of 28.96 (+/- 1.98) and 10.04 (+/- 0.87) respectively. 71% patients did not need any homologous blood transfusion. Prothrombin time index (PTI%) showed 7.5% fall at the conclusion of blood retransfusion and 3.94% fall on the day of discharge. Technique is safe, avoids use of homologous blood and is thus recommended during surgical correction of complicated high velocity vascular injury of limbs.