Acute hemodilution in a chronic polycythemic patient may be deleterious

ALTHOUGH data from animal studies of acute polycythemia show that this cond ition is associated with a decreased cardiac output and increased systemic vascular resistance (SVR) because of an increased blood viscosity,(1-3) thi s is not confirmed in man. In contrast to polycythemia, acute isovolemic he modilution leads to an increase in cardiac output, a decrease in SVR, and a n increase in the oxygen extraction. However, there is no report in the lit erature on the effects of acute isovolemic hemodilution in a polycythemic i ndividual. We describe the treatment and the effects of acute hemodilution in a patient with chronic polycythemia undergoing surgery for an erythropoi etin-producing renal tumor.