HEMODILUTION IN COMPLICATED HIGH-VELOCITY - VASCULAR INJURIES OF LIMBS

Normovolemic hemohemodilution with 3,5% polygeline was carried out in fourteen ASA (American Society of Anesthesiologists) Class-I patients, who had developed false aneurysms or arteriovenous fistulas following high velocity injury on limbs. At the end of surgical procedure volum e of mean blood drained was 1400.00+/-194.46 ml, mean surgical blood l oss was 1665.71 (+/-33.9) ml and fluid balance was 557.14 (+/-176.40) ml. Arteriovenous oxygen content difference (C-(a-v) O-2), central ven ous pressure (CVP), heart rate and mean arterial pressure (MAP) did no t show any significant variation from pre-hemorrhage value. Hematocrit (Hct%) and hemoglobin (Hb gm%) showed a highly significant fall follo wing hemodilution and retransfusion. However on the day of discharge H ct% (37.5 (+/-3.88) and Hb gm% (12.84 (+/-0.82) had increased from pos t hemodilution value of 28.96 (+/-1.98) and 10.04 (+/-0.87) respective ly. 71% patients did not need any homologous blood transfusion. Prothr ombin time index (PTI%) showed 7.5% fall at the conclusion of blood re transfusion and 3.94% fall on the day of discharge. Tecnique is safe, avoids use of homologous blood and is thus recommended during surgical correction of complicated high velocity vascular injury of limbs.