Pressure-dependent changes in haematocrit and plasma volume during anaesthesia, a randomised clinical trial

Acta Anaesthesiologica Scandinavica
T DaménA Nygren

Abstract

Induction of general anaesthesia has been shown to cause haemodilution and an increase in plasma volume. The aim of this study was to evaluate whether prevention of hypotension during anaesthesia induction could avoid haemodilution. Twenty-four cardiac surgery patients, 66 ± 10 years, were randomised to receive either norepinephrine in a dose needed to maintain mean arterial blood pressure (MAP) at pre-anaesthesia levels after induction or to a control group that received vasopressor if MAP decreased below 60 mmHg. No fluids were infused. Changes in plasma volume were calculated with standard formula: 100 × (Hct(pre)/Hct(post) - 1)/(1 - Hct(pre)). Arterial blood gas was analysed every 10 minutes and non-invasive continuous haemoglobin (SpHb) was continuously measured. Pre-anaesthesia MAP was 98 ± 7 mmHg. Ten minutes after anaesthesia induction, the haematocrit decreased by 5.0 ± 2.5% in the control group compared with 1.2 ± 1.4% in the intervention group, which corresponds to increases in plasma volume by 310 ml and 85 ml respectively. MAP decreased to 69 ± 15 mmHg compared to 92 ± 10 mmHg in the intervention group. The difference maintained throughout the 70 min intervention period. The change in haemoglobin level measured by ...Continue Reading

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Citations

Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Domenico PaganoChrista Boer
Jul 3, 2018·Acta Anaesthesiologica Scandinavica·Junichi Saito, Kazuyoshi Hirota
Jul 5, 2018·Acta Anaesthesiologica Scandinavica·Tor Damén, Andreas Nygren
Sep 24, 2020·Acta Anaesthesiologica Scandinavica·Tor DaménAndreas Nygren

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