Effects of acute normovolemic hemodilution plus low central venous pressure on coagulation function in patients undergoing liver cancer resection
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R675.3

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    Abstract:

    Objective: To investigate the effects of acute normovolemic hemodilution plus low central venous pressure (ANH+LCVP) on coagulation function in patients undergoing liver cancer resection. Methods: Forty liver cancer patients with ASA I-II physical status scheduled for liver resection were equally designated to observational group and control group. Patients in observational group underwent ANH after general anesthesia, and controlled LCVP was performed from the time that the patients entered the operating room to the completion of liver parenchyma transection, while those in control group received the conventional treatment only. The intra- and postoperative blood loss, the number of patients undergoing second operation due to intra-abdominal hemorrhage, and the parameters that included hemoglobin (Hb) level, hematocrit (HCT), platelet (PLT) count, fibinoger (FIB) concentration, activated partial thromboplastin time (APTT), prothrombin time (PT), and international normalized ratio (INR) as well as activated clotting time (ACT), clot rate (CR) and platelet function (PF) in different time points were recorded. Results: The intraoperative blood loss in observational group was significantly less than that in control group (P<0.05), but the postoperative blood loss showed no significant difference between the two groups (P>0.05), and no case of either group required a second operation due to secondary hemorrhage. In observational group, the values of Hb, HCT, PLT, FIB, CR and PF were significantly decreased while the values of APTT, PT, INR and ACT were significantly increased at the time after blood collection, after liver cancer resection, and after intravascular volume restoration compared with their values before surgery, but these parameters were obviously improved after intravascular volume restoration compared to that after liver cancer resection. In control group, the values of Hb, HCT, PLT, FIB, CR and PF were progressively decreased while the values of APTT, PT, INR and ACT were progressively increased during the period from the beginning to the completion of operation. All the studied parameters in observational group were better than those in control group (P<0.05). Conclusion: ANH+LCVP technique can reduce the intraoperative blood loss, but has certain influence on the coagulation function, which does not lead to abnormal bleeding in liver cancer resection, so it can be safely used in liver cancer resection.

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WU Zhiyun, ZHA Benjun, DENG Sha, WANG Yongsheng, XIE Ping. Effects of acute normovolemic hemodilution plus low central venous pressure on coagulation function in patients undergoing liver cancer resection[J]. Chin J Gen Surg,2014,23(1):28-32.
DOI:10.7659/j. issn.1005-6947.2014.01.006

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History
  • Received:December 12,2012
  • Revised:September 24,2013
  • Adopted:
  • Online: January 15,2014
  • Published: