Document Detail

Influence of hematocrit on cardiopulmonary function after acute hemorrhage.
MedLine Citation:
PMID:  3560265     Owner:  NLM     Status:  MEDLINE    
The 'optimal' hematocrit to which patients should be resuscitated after shock and trauma is controversial. To test the hypothesis that sufficient oxygen delivery can be provided at a lower hematocrit without impairing oxygen consumption or hemodynamic function, 25 patients were prospectively studied immediately following injury and/or acute hemorrhage. Patients were randomized to have their hematocrits (HCT) maintained near 30% (29.7 +/- 0.4% (M +/- SEM); n = 12) or 40% (38.4 +/- 0.6%, n = 13). Cardiopulmonary parameters were measured twice a day for 3 days. Statistical analysis used a repeated measures analysis of variance with patient age, and ventilator parameters (FIO2, PEEP, and ventilator mode) as covariates. Arterial and venous O2 saturations were not significantly different at different hematocrits, although arterial and venous O2 contents were lower at 30% HCT (a = 14.1 +/- 0.2 m10(2)/dl, v = 10.1 +/- 0.3 m10(2)/dl; vs. a = 17.4 +/- 0.4 m10(2)/dl, v = 13.6 +/- 0.6 m10(2)/dl; p less than 0.05). This resulted in a lower oxygen delivery at the lower HCT. Between the two groups, there also was no significant difference in cardiac index (overall mean, 3.64 +/- 0.16 ml/min/m2), heart rate (99 +/- 4 bpm), systemic vascular resistance (1,058 +/- 55 dyne-sec/cm5), or left ventricular stroke work index (4.3 +/- 0.3 X 10(6) dyne-cm/m2). Intrapulmonary shunt was higher with higher hematocrit (22.6 +/- 2.4% at 40% HCT vs. 14.6 +/- 1.6% at 30% HCT; p less than 0.05) with no difference in end-expiratory pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
J B Fortune; P J Feustel; J Saifi; H H Stratton; J C Newell; D M Shah
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of trauma     Volume:  27     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1987 Mar 
Date Detail:
Created Date:  1987-05-08     Completed Date:  1987-05-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  243-9     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Heart / physiology*
Lung / metabolism*,  physiology
Myocardium / metabolism*
Oxygen / metabolism*
Oxygen Consumption*
Prospective Studies
Random Allocation
Shock, Hemorrhagic / metabolism*,  physiopathology
Grant Support
Reg. No./Substance:

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