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The role of acute normovolemic hemodilution in reducing allogeneic blood transfusion in glioblastoma surgery:a case-control study

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Chinese Neurosurgical Journal 2024年第1期10卷 35-41页

作者： Ping Chen Xin‑Huang Zhang Ying Wang Xian‑Zhong Lin De‑Zhi Kang Qing‑Song Lin Department of Anesthesiology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005FujianChina Department of Neurosurgery The First Affiliated Hospital of Fujian Medical UniversityNo.20 Chazhong RdTaijiang DistrictFuzhou 350005FujianChina Department of Neurosurgery Binhai Branch of National Regional Medical CenterThe First Affiliated Hospital of Fujian Medical UniversityFuzhou 350209FujianChina Fujian Provincial Institutes of Brain Disorders and Brain Sciences The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005FujianChina Fujian Provincial Clinical Research Center for Neurological Diseases The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005FujianChina Fujian Provincial Key Laboratory of Precision Medicine for Cancer The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005FujianChina

Background acute normovolemic hemodilution(ANH)was first introduced in glioblastoma surgery,and its role in reducing allogeneic blood transfusion was investigated in this *** This study enrolled supratentorial glioblastoma patients who received total *** the ANH group,the patients were required to draw blood before the operation,and the blood will be transfused back to the patient during the *** association between ANH and clinical features was *** Sixty supratentorial glioblastoma patients were enrolled in this study,25 patients were allocated in the ANH group,and another 35 patients were included in the control *** dramatically reduced the need for allogeneic blood transfusion(3[12%]vs 12[34.3%],P=0.049),and the blood transfusion per total of patients was dramatically decreased by the application of ANH(0.40±1.15 units vs 1.06±1.59 units,P=0.069).Furthermore,ANH also markedly reduced the requirement of fresh frozen plasma(FFP)transfusion(2[8%]vs 11[31.4%],P=0.030)and the volume of FFP transfusion per total of patients(32.00±114.46 mL vs 115.71±181.00 mL,P=0.033).The complication rate was similar between the two *** ANH was a safe and effective blood conservation technique in glioblastoma surgery.

关键词： Glioblastoma acute normovolemic hemodilution Surgery Blood transfusion

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Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution

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Military Medical Research 2021年第2期8卷 183-195页

作者： Guo-Xing You Bing-Ting Li Zhen Wang Quan Wang Ying Wang Jing-Xiang Zhao Lian Zhao Hong Zhou Institute of Health Service and Transfusion Medicine Beijing 100850China

Background:Plasma expanders are widely used for acute normovolemic hemodilution(ANH).However,existing studies have not focused on large-volume infusion with colloidal plasma expanders,and there is a lack of studies that compare the effects of different plasma ***:The viscosity,hydrodynamic radius(Rh)and colloid osmotic pressure(COP)of plasma expanders were determined by a cone-plate viscometer,Zetasizer and cut-off membrane,*** male rats were randomized into five groups with Gelofusine(Gel),Hydroxyethyl Starch 200/0.5(HES200),Hydroxyethyl Starch 130/0.4(HES130),Hydroxyethyl Starch 40(HES40),and Dextran 40(Dex40),with 12 rats used in each group to build the ANH *** was performed by the withdrawal of blood and simultaneous infusion of plasma ***-base,lactate,blood gas and physiological parameters were ***:Gel had a lower intrinsic viscosity than HES200 and HES130(P<0.01),but at a low shear rate in a mixture of colloids,red cells and plasma,Gel had a higher viscosity(P<0.05 or P<0.01,respectively).For hydroxyethyl starch plasma expanders,the COP at a certain concentration decreases from 11.1 mmHg to 6.1 mmHg with the increase of Rh from 10.7 nm to 20.2 nm.A severe ANH model,with the hematocrit of 40%of the baseline level,was established and accompanied by disturbances in acid-base,lactate and blood gas *** the end of ANH and 60 min afterward,the Dex40 group showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other *** systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)decreased significantly in all groups at the end of *** DBP and MAP in the Dex40 group further decreased 60 min after the end of *** the process of ANH,the Dex40 group showed a drop and recovery in SBP,DBP and *** DBP and MAP in the HES200 group were significantly higher than those in the other groups at some time points(P<0.05 o

关键词： acute normovolemic hemodilution Plasma expander Acid-base Lactate Blood gas Physiological arameters

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