Acute normovolemic hemodilution (ANH). Effects of ANH on leftventricular diastolic function [Akute normovolamische hamodilution (ANH): Effekte der ANH auf die diastolische funktion des linken ventrikels]

被引：0
作者：
Habler O. [1 ]
Kleen M. [1 ]
Podtschaske A. [3 ]
Hutter J. [2 ]
Tiede M. [1 ]
Kemming G. [1 ]
Meßmer K. [2 ]
机构：
[1] Klinik für Anästhesiologie, Ludwig-Maximilians-Universität, München
[2] Institut für Chirurgische Forschung, Ludwig-Maximilians-Universität, München
[3] Abteilung für Anästhesiologie und Operative Intensivmedizin, Kreiskrankenhaus München-Pasing, München
来源：
Der Anaesthesist | 2000年 / 49卷 / 11期
关键词：
Acute normovolemic hemodilution; ANH; Conductance technique; Diastolic relaxation; Pigs; Radioactive microspheres technique; Ventricular function;
D O I：
10.1007/s001010070029
中图分类号：
学科分类号：
摘要：
Ischemia-induced changes of diastolic leftventricular (LV) properties commonly precede corresponding ECG-changes. In the present experimental study the consequences of acute normovolemic hemodilution (ANH) induced dilutional anemia (hematocrit, hct 20%) for LV diastolic function were investigated. A total of 22 anaesthetized, splenectomized beagle dogs breathing room air were hemodiluted with isooncotic hydroxyethylstarch solution (6%HAES 200.000/0.5) until a hct value of 20% was reached. Before and after ANH intravascular blood volume (indocyaningreen dilution technique), global and regional myocardial blood flow (radioactive microspheres technique) and the following parameters reflecting LV diastolic properties were ascertained: 1) the maximum rate of LV pressure decrease (LVdp/dt(min)), 2) slope and intercept of the enddiastolic pressure-volume relationship (EDPVR, conductance technique) and 3) the time-constant of isovolumic LV pressure decline 'τ'. After ANH to hct 20% diastolic LV function was found unchanged. Particularly the load-independent parameters (EDPVR-slope and τ) remained constant. The decrease of LV dp/dt(min) (-2724±479 vs.-2388±408 mmHg·sek -1;p<0.05) reflects ANH induced changes of LV pre- and afterload. Signs of subendocardial perfusion mismatch were not encountered. Presumed that the coronary vascular system is intact ANH to hct 20% does not provoque changes of LV diastolic function. Moreover neither myocardial perfusion and oxygenation nor myocardial function are endangered by this degree of dilutional anemia.
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页码：939 / 948
页数：9
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