Effect of acute hypervolemic hemodilution with hydroxyethyl starch 130/0.4 on hemorheology and microcirculation in patients with finger replantation

    NIU Jiª²Yuan, YAO Liª²Nong, SUN Xuª²De, ZHANG Xiaoª²Feng, YANG Yongª²Hui, LIU Xiaoª²Feng, CHAI Wei

    Department of Anesthesia, Tangdu Hospital, Fourth Military Medical University, Xi¬ðan 710038, China

    ¡¾Abstract¡¿ AIM: To observe the changes of hemorheology and microcirculation in patients with finger replantation after acute hypervolemic hemodilution (AHHD) using hydroxyethyl starch(HES, 130/0.4). METHODS: Forty patients(ASA¢ñª²¢ò) were randomly divided into 2 groups (n=20 per group) and received intravenous infusion of HES (130/0.4) and Ringer¬ðs solution before operation to make Hct decrease to 30% . Anaesthetic method was continuous interscalene brachial plexus block. During operation, only Ringer¬ðs solution was used. After vascular anastomosis and blood reflowing, the microcirculation was observed and compared in the 2 groups and hemorheology index was measured before and after operation. RESULTS: The whole blood viscosity, Hct, capillary filling time and platelet aggregation rate margin in HES (130/0.4) group were significantly less than those in the control group (P<0.05) . SPO2 was higher than that in Ringer¬ðs solution group (P<0.05). CONCLUSION: AHHD with HES (130/0.4) can effectively maintain a stable hemodynamic status, improve the perfusion of microcirculation and local oxygen supply and promote the success rate of finger replantation. ......