DOES TIMING OF HEMODILUTION INFLUENCE THE STRESS RESPONSE AND OVERALLOUTCOME

This study was designed to assess the stress response of acute hemodil ution (AH) in patients subjected to radical cystectomy. Forty adult ma le patients were randomly allocated into a control group (n = 10) wher e homologous blood transfusion was used, a preinduction AH group (n = 20) where AH was performed before lumbar epidural block and induction of anesthesia, and into a postinduction group (n = 10) where AH was pe rformed after induction of anesthesia. Monitored variables included he modynamic, hematological and coagulation factors, liver function tests , and serum hormones. AH performed in awake or in anesthetized patient s did not result in significant hemodynamic disruption, or result in d etectable end-organ or stress-hormone changes when compared to control patient outcomes after radical cystectomy. Hemodilution can be perfor med by protocol for patients who are undergoing this procedure without major adverse effects.