Document Detail

Haemodilution tolerance in patients with mitral regurgitation.
MedLine Citation:
PMID:  9505737     Owner:  NLM     Status:  MEDLINE    
Haemodynamic parameters and oxygen consumption were determined in 20 patients with mitral regurgitation before and after a 12 isovolaemic exchange of blood for 6% hydroxyethyl starch. During haemodilution, mean (SEM) haemoglobin concentration decreased from 13.0 (0.4) to 10.3 (0.4) g.dl-1 (p = 0.001). With cardiac filling pressures maintained at predilution levels, cardiac index increased from 1.84 (0.08) to 1.94 (0.08) l.min-1.m-2 (p = 0.025) while systemic vascular resistance decreased from 1556 (86) to 1425 (83) (p = 0.002) and oxygen extraction increased from 31.7 (1.1) to 37.3 (1.4)% (p = 0.001) resulting in an unchanged oxygen consumption. The haemodynamic response to haemodilution was not affected by the patients' cardiac rhythm, i.e. whether it was sinus rhythm or atrial fibrillation. In conclusion, isovolaemic haemodilution to a haemoglobin of 10.3 g.dl-1 is well tolerated in patients with mitral regurgitation. Compensatory mechanisms include both an increase in cardiac index and an increase in oxygen extraction.
D R Spahn; B Seifert; T Pasch; E R Schmid
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  53     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-25     Completed Date:  1998-03-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  20-4     Citation Subset:  AIM; IM    
Institute of Anaesthesiology, University Hospital, University of Zürich, Switzerland.
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MeSH Terms
Atrial Fibrillation / physiopathology
Cardiac Output
Hemoglobins / metabolism
Intraoperative Care
Middle Aged
Mitral Valve Insufficiency / blood,  physiopathology*,  surgery*
Oxygen Consumption
Plasma Substitutes
Vascular Resistance
Reg. No./Substance:
0/Hemoglobins; 0/Plasma Substitutes; 9005-27-0/Hetastarch

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