EFFECTS OF HYPERTONIC SALINE DEXTRAN ON THE POSTOPERATIVE EVOLUTION OF JEHOVAH-WITNESS PATIENTS SUBMITTED TO CARDIAC-SURGERY WITH CARDIOPULMONARY BYPASS

Hypertonic saline-dextran (HSD) solutions have been used for hemorrhag ic shock, aortic aneurysm, and cardiopulmonary bypass surgery (CPB). J ehovah's Witness patients refuse blood and derivatives even under life -threatening conditions. A negative fluid balance for Jehovah's Witnes ses would avoid further hemodilution. In this study we compared clinic al, hemodynamic, laboratory evolution, and fluid balance of 20 Jehovah 's Witnesses over the first 72 h following CPB. Ten received HSD immed iately prior to CPB. All patients survived and were maintained in stab le hemodynamic and metabolic condition throughout the study period. HS D induced high cardiac output, low vascular resistance immediately aft er administration. Vascular resistance remained low until the end of C PB. HSD patients ran a slightly negative fluid balance, while control patients ran a large positive fluid balance. HSD pretreatment is now u sed routinely for Jehovah's Witnesses undergoing CPB in our facility.