Anesthesia and analgesia
-
Anesthesia and analgesia · May 1994
ReviewCardiovascular and coronary physiology of acute isovolemic hemodilution: a review of nonoxygen-carrying and oxygen-carrying solutions.
Acute isovolemic hemodilution is used increasingly to avoid the potentially serious side effects of homologous blood transfusions. Cardiovascular physiology during hemodilution is characterized by a marked increase in cardiac output and organ blood flow to compensate for the decrease in arterial oxygen-carrying capacity. During advanced hemodilution an increased oxygen extraction is also observed, such that oxygen consumption generally is maintained even during advanced hemodilution. ⋯ Cardiac output is generally constant and oxygen extraction is increased to maintain oxygen consumption during hemodilution with hemoglobin solutions. In most studies, some vasoconstriction was observed also, which might result from interaction of the hemoglobin molecule with the EDRF/NO system. However, with enhanced purification, chemical modification or microencapsulation of the hemoglobin molecule, vasoconstriction can be limited.