scholarly journals Crystalloids versus colloids during acute normovolemic anemia: the quest continues...

Critical Care ◽  
2012 ◽  
Vol 16 (3) ◽  
pp. 131 ◽  
Author(s):  
Karl Schebesta ◽  
Oliver Kimberger
Keyword(s):  
1994 ◽  
Vol 111 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Ilsa Schwartz ◽  
Kun Z. Kim ◽  
David H. Thompson ◽  
Thomas F. George ◽  
Patrick M. McQuillan ◽  
...  

The decision to transfuse patients after major head and neck reconstructive surgery has been influenced by the dictum that a hematocrit level of 30% or more is necessary for the survival of surgical flaps. Pedicled myocutaneous flaps are among the most frequently used methods of reconstruction after major head and neck oncologic surgery. No studies have addressed the survival of myocutaneous pedicied flaps in anemic animals. In this study survival of latissimus dorsi myocutaneous flaps in pigs was evaluated in anemic and control groups. A total of 26 pigs were randomly divided into two groups. The pigs in the anemic group were exsanguinated to normovolemic anemia (average hematocrit, 19%), followed by elevation of a latissimus dorsi myocutaneous flap. In the control group the same operation was performed without exsanguination. All other variables were kept constant. The flap survival was judged on postoperative3 days 7, and 14 by two evaluators. Ten pigs from each group were found to have 100% flap survival on postoperative day 14. There was no significant difference in mean flap survival rates between two groups for postoperative3 days 7, and 14. It is concluded that normovolemic anemia does not adversely affect the survival of the myocutaneous flaps. This finding may save unnecessary transfusions in postoperative patients.


1962 ◽  
Vol 203 (4) ◽  
pp. 720-724 ◽  
Author(s):  
John F. Murray ◽  
Philip Gold ◽  
B. Lamar Johnson

The hemodynamic effects of normovolemic anemia and polycythemia were studied in 14 dogs. Anemia (5 dogs) and polycythemia (5 dogs) were induced by bleeding and simultaneously infusing dextran or packed erythrocytes. Measurements included cardiac output, arterial oxygen saturation, peripheral vascular resistance, and systemic oxygen transport (cardiac output X arterial oxygen content). Cardiac output had a significant negative linear relationship to hematocrit ( r = –0.74, P < 0.01) over the range studied (13–74%). Peripheral resistance fell 46% in anemic animals and increased 152% in four of five polycythemic animals. Arterial saturation was significantly correlated to changes in hematocrit ( r = 0.62, P < 0.01) and cardiac output ( r = –0.55, P < 0.01); these values were due primarily to the linearity encountered in the anemia experiments and a reversal in these relationships tended to occur at high hematocrits. Systemic oxygen transport was maximum at normal hematocrits and decreased in anemia and polycythemia. The data indicate that hemodynamic adjustments in normovolemic anemia and polycythemia are insufficient to maintain normal oxygen delivery.


2008 ◽  
Vol 25 (Sup 44) ◽  
pp. 50
Author(s):  
P. Lauscher ◽  
H. Kertscho ◽  
L. Raab ◽  
O. Habler ◽  
J. Meier

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 65 ◽  
Author(s):  
O. Horn ◽  
A. Pape ◽  
H. Kertscho ◽  
B. Zwissler ◽  
O. Habler

2004 ◽  
Vol 77 (9) ◽  
pp. 1394-1398 ◽  
Author(s):  
Bruno Jawan ◽  
Vanessa de Villa ◽  
Hsiang-Ning Luk ◽  
Chih-Shien Wang ◽  
Chia-Jung Huang ◽  
...  

2002 ◽  
Vol 97 (5) ◽  
pp. 1189-1197 ◽  
Author(s):  
Valéria Perez-de-Sá ◽  
Roger Roscher ◽  
Doris Cunha-Goncalves ◽  
Anders Larsson ◽  
Olof Werner

Background The benefits of hypothermia during acute severe anemia are not entirely settled. The authors hypothesized that cooling would improve tolerance to anemia. Methods Eight normothermic (38.0 +/- 0.5 degrees C) and eight hypothermic (32.0 +/- 0.5 degrees C) pigs anesthetized with midazolam-fentanyl-vecuronium-isoflurane (0.5% inspired concentration) were subjected to stepwise normovolemic hemodilution (hematocrit, 15%, 10%, 7%, 5%, 3%). Critical hemoglobin concentration (Hgb(CRIT)) and critical oxygen delivery (DO(2CRIT)), i.e., the hemoglobin concentration (Hgb) and oxygen delivery (DO2) at which oxygen consumption (VO2, independently measured by indirect calorimetry) was no longer sustained, and Hgb at the moment of death, defined prospectively as the point when VO2, decreased below 40 ml/min, were used to assess the tolerance of the two groups to progressive isovolemic anemia. Results At hematocrits of 15% and 10% (Hgb, 47 and 31 g/l), VO2 was maintained in both groups by an increase (P &lt; 0.001) in cardiac output (CO) and extraction ratio (ER; P&lt; 0.001) with unchanged mean arterial lactate concentration (L(art)). At hematocrit of 7% (Hgb, 22 g/l), all normothermic but no hypothermic animals had DO2-dependent VO2. No normothermic and three hypothermic animals survived to 5% hematocrit (Hgb, 15 g/l), and none survived to 3%. Hgb(CRIT) was 23 +/- 2 g/l and 19 +/- 6 g/l (mean +/- SD) in normothermic and hypothermic animals, respectively (P = 0.053). Hgb at death was 19 +/- 3 g/l versus 14 +/- 4 g/l (P = 0.015), and DO(2CRIT) was 8.7 +/- 1.7 versus 4.6 +/- 0.8 ml x kg(-1) x min(-1) (P &lt; 0.001). Conclusion During progressive normovolemic hemodilution in pigs, hypothermia did not significantly change Hgb(CRIT), but it decreased the Hgb at death, i.e., short-term survival was prolonged.


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