Impact of Acute Normovolemic Hemodilution on Blood Viscosity

Konkuk University Medical Center

Status: Completed

Conditions: Coronary Artery Disease; Ischemic Heart Disease

Treatments: Procedure: In-vitro hemodilution; Procedure: acute normovolemic hemodilution

Study type: Interventional

Funder types: Other

Identifiers

NCT03366753

KUH1160102

Details and patient eligibility

About

Acute normovolemic hemodilution (ANH) has long been employed for reducing allogenic blood transfusion for cardiac surgery, and hydroxyethyl starch has been used as an intravenous replacement fluid during ANH procedure. However, possible impact of ANH employing HES on blood viscosity and oxygen delivery have not been well investigated in patients undergoing off-pump coronary artery bypass (OPCAB) surgery .

Anesthesia is induced and maintained by using propofol-remifentanil-rocuronium in OPCAB surgery (n=21). ANH is performed by using 5 ml/kg of blood salvage and administering 5 ml/kg of balanced HES 130/0.42 (Tetraspan™) for 15 min during vascular graft harvesting. For the present study, three arterial blood samples (3 ml each) are taken before (Sample 1) and after ANH (sample 2 and 3) and they are stored in 3 tubes. Sample 3 (in tube) undergoes further 30% in-vitro dilution by adding 1-1.5 ml HES. By using a scanning capillary tube viscometer (Hemovister™), Blood viscosity at low shear rate (5/sec) of the three samples are determined. By using a formula with blood viscosity and hematocrit, tissue O2 delivery index (TODI, = hematocrit/viscosity at 5/sec) is calculated.

Enrollment: 21 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients undergoing off-pump coronary artery bypass graft surgery

Exclusion criteria

• Preoperative anemia
• LV ejection fraction < 50%

Trial design

Primary purpose: Supportive Care

Allocation: Non-Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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21 participants in 2 patient groups

Acute normovolemic hemodilution

Experimental group

Description:

acute normovolemic hemodilution by using hydroxyethyl starch

Treatment:

Procedure: acute normovolemic hemodilution

Procedure: In-vitro hemodilution

In-vitro hemodilution

Experimental group

Description:

adding additional hydroxyethyl starch for achieving further 30% dilution of whole blood sample which already underwent ANH of 4-6 ml/kg.

Treatment:

Procedure: In-vitro hemodilution