THE PRESERVATION OF RENAL-FUNCTION BY ISOVOLEMIC HEMODILUTION DURING AORTIC OPERATIONS

Purpose: In an investigation of the effects of isovolemic hemodilution , 39 consecutive patients undergoing elective infrarenal aortic operat ion had detailed measurements of renal function, renal artery blood fl ow, and cardiac hemodynamics. Methods: The patients were randomly allo cated to receive acute preoperative isovolemic hemodilution to a hemat ocrit of 28%, with 20 patients receiving hemodilution and 19 being con trol subjects. Results. Twelve (63%) of the control group had renal im pairment, compared with only four (20%) in the group receiving hemodil ution (p < 0.01). Hemodilution also prevented the fall in cardiac outp ut induced by cross-clamping (p < 0.01) and significantly reduced the need for transfusion of donor blood (p < 0.01).Conclusions: Acute isov olemic hemodilution is clearly a useful adjunct in the management of p atients undergoing elective aortic operation.