The effect of acute hypervolemic hemodilution on blood gas and electrolytes
Yanqiu Ai · Medical Information · 2006
Objective To compare the effect of acute hypervolemic hemodilution by Lactated Ringer's solution、Voluven and Gelofusine on blood gas and electrolytes. Methods Thirty patients undergoing scheduled elective meningioma operation were randomly divided into 3 groups: Group Ⅰ(AHHD with lactated Ringer's solution), Group Ⅱ (AHHD with voluven), Group Ⅲ(AHHD with gelofusine), with 10 in each group. AHHD was performed by infusing 20ml/(h.kg) solution 30 minutes before induction and infusing 20ml/(h.kg)solution 30 minutes during and after induction, then the operation was began. Collected arterial blood samples before AHHD (T1)、at the end of AHHD(T2)、 60 minutes after AHHD (T3)、 120 minutes after AHHD(T4) respectively for determining blood gas and electrolytes. Results Within three groups, after AHHD the HCT decreased significantly at T2、T3、T4 compared with T1 P0.01.At the end of AHHD,HCT decreased by 8.9% in group Ⅰ, 24.8% in group Ⅱ, 17.1% in group Ⅲ compared with T1. Changes on PH and K+, Compared with T1,there were no significant differences at T2、T3、T4 P0.05. Compared with before AHHD,HCO_3-、PaCO_2 decreased significantly after AHHD P0.01. Compared with before AHHD, Na+、CL-increased significantly at the end of AHHD P0.01; Ca 2+ decreased significantly at the end of AHHD in group Ⅱ and group Ⅲ P0.01. Conclusions AHHD before operation can maintain stable hemodynamics, Voluven and gelofusine are more reliable than lactated Ringer' s solution in its volume expansion effect and voluven is better than gelofusine ; AHHD has no significant effect on blood gas; After AHHD CL-increased in three groups, and Ca 2+ decreased in group Ⅱ and group Ⅲ . Attentions should be taken and supplement Ca 2+ necessarily.