Document Detail


Acute Normovolemic Hemodilution Effects on Perioperative Coagulation in Elderly Patients Undergoing Hepatic Carcinectomy.
MedLine Citation:
PMID:  24083696     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Acute normovolemic hemodilution (ANH) has been widely used to prevent the massive blood loss during hepatic carcinoma. The influences of ANH on coagulation function are still controversy, especially in elderly patients. The study observed ANH effects on coagulation function and fibrinolysis in elderly patients undergoing the disease. Materials and Methods: Thirty elderly patients (aged 60-70 yr) with liver cancer (ASA I or II) taken hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n=15) and control group (n=15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (130/0.4) and Ringer's solution, respectively. Blood samples were drawn from patients in both groups at five different time points: before anesthesia induction (T1), 30 min after ANH (T2), 1 h after start of operation (T3), immediately after operation (T4), and 24 h after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (CD62P and activated GP IIb/GP IIIa) were measured. Results: The perioperative blood loss and allogeneic blood transfusion were recorded during the surgery. The perioperative blood loss was not significantly different between two groups (p>0.05), but the volume of allogeneic blood transfusion in ANH group was significantly less than in control group (350.0±70.7) mL vs. (457.0±181.3) mL (p<0.01). Compared with the data of T1, the prothrombin time (PT) and activated partial thromboplastin time (APTT) measured after T3 were significantly longer (p<0.05) in both groups, but within normal range. There were no significant changes of thrombin time (TT) and D-dimer between two groups at different time points (p>0.05). SFMC and F1+2 increased in both groups, but were not statistically significant. PAC-1-positive cells and CD62P expressions in patients of ANH group were significantly lower than those at T1 (p<0.05) and T2-T5 (p>0.05). Conclusions: ANH has no obvious impact on fibrinolysis and coagulation function in elderly patients undergoing resection of liver cancer. The study suggested that ANH is safe to use in elderly patients and it could reduce allogeneic blood transfusion.
Authors:
Jian-Rong Guo; Xiao-Ju Jin; Jun Yu; Feng Xu; Yi-Wei Zhang; Hua-Chun Shen; Yi Shao
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Asian Pacific journal of cancer prevention : APJCP     Volume:  14     ISSN:  1513-7368     ISO Abbreviation:  Asian Pac. J. Cancer Prev.     Publication Date:  2013  
Date Detail:
Created Date:  2013-10-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130625     Medline TA:  Asian Pac J Cancer Prev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  4529-4532     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, Shanghai Gongli Hospital of Pudong New District, Shanghai, China E-mail : jrgmail@163.com.
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