Hemodilution during bone marrow harvesting in children
(1991) In Anesthesia and Analgesia 72(5). p.645-650- Abstract
- Eight children (1--17 yr) underwent bone marrow harvesting while in cytostatic-induced remission of their disease (leukemia [n = 6], Ewing sarcoma, and non-Hodgkin lymphoma). After the induction of general anesthesia, all patients were loaded with 10 mL/kg of a 6% high-molecular dextran solution (Macrodex — Pharmacia), which resulted in a significant preoperative decrease in hematocrit (Hct) from 32% ± 6% to 28% ± 5% (hypervolemic hemodilution) and also allowed the procedure to be performed without systemic heparinization. The blood aspirated during the harvest (24 ± 6 mL/kg; mean ± SD) was replaced with a solution of 6% dextran and Ringer's acetate solution, and the Hct decreased from 28% ± 5% to a minimum of 18% ± 3%. Immediately after... (More)
- Eight children (1--17 yr) underwent bone marrow harvesting while in cytostatic-induced remission of their disease (leukemia [n = 6], Ewing sarcoma, and non-Hodgkin lymphoma). After the induction of general anesthesia, all patients were loaded with 10 mL/kg of a 6% high-molecular dextran solution (Macrodex — Pharmacia), which resulted in a significant preoperative decrease in hematocrit (Hct) from 32% ± 6% to 28% ± 5% (hypervolemic hemodilution) and also allowed the procedure to be performed without systemic heparinization. The blood aspirated during the harvest (24 ± 6 mL/kg; mean ± SD) was replaced with a solution of 6% dextran and Ringer's acetate solution, and the Hct decreased from 28% ± 5% to a minimum of 18% ± 3%. Immediately after the harvest, 10 mL/kg of homologous packed red blood cells was transfused, increasing Hct to 25% ± 3%. Oxygen saturation in the superior caval vein (Scvo2) decreased from 79% ± 4% before the harvest to 70% ± 3% (P < 0.01) at the end of it, and then increased to 74% ± 3% after the transfusion of homologous packed red blood cells. There was a strong linear correlation between mean values for Hct and Scvo2 during the various stages (r = 0.99). Mean heart rate decreased gradually during the procedure, from 106 ± 10 to 86 ± 7 beatslmin. There was no significant change in arterial pressure, but cardiac output measured by impedance cardiography was about 30% greater during harvesting than during undisturbed anesthesia. Pulse oximetric saturation was 99% or 100% throughout. Caval venous blood lactate and pyruvate concentrations remained within normal limits in all children. Recovery after anesthesia was uneventful, except in one child in whom severe shivering developed. H is concluded that the hemodilution resulted in a statistically but not clinically significant decrease in Scvo2 that was well tolerated by the patients as judged from hemodynamic responses as well as levels of arterial oxygen saturation (Sao2) and blood lactate. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1105638
- author
- Perez de Sá, Valéria LU ; Békássy, Albert LU ; Schou, Henning LU ; Werner, Mads LU and Werner, Olof LU
- organization
- publishing date
- 1991
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- HEMODILUTION—bone marrow harvesting, ANESTHESIA, BONE MARROW HARVESTING, BLOOD
- in
- Anesthesia and Analgesia
- volume
- 72
- issue
- 5
- pages
- 645 - 650
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:2018222
- scopus:0025856368
- ISSN
- 1526-7598
- language
- English
- LU publication?
- yes
- id
- bb82039d-a51e-4951-b37b-021f5ece859e (old id 1105638)
- date added to LUP
- 2016-04-01 15:54:11
- date last changed
- 2021-09-19 04:58:30
@article{bb82039d-a51e-4951-b37b-021f5ece859e, abstract = {{Eight children (1--17 yr) underwent bone marrow harvesting while in cytostatic-induced remission of their disease (leukemia [n = 6], Ewing sarcoma, and non-Hodgkin lymphoma). After the induction of general anesthesia, all patients were loaded with 10 mL/kg of a 6% high-molecular dextran solution (Macrodex — Pharmacia), which resulted in a significant preoperative decrease in hematocrit (Hct) from 32% ± 6% to 28% ± 5% (hypervolemic hemodilution) and also allowed the procedure to be performed without systemic heparinization. The blood aspirated during the harvest (24 ± 6 mL/kg; mean ± SD) was replaced with a solution of 6% dextran and Ringer's acetate solution, and the Hct decreased from 28% ± 5% to a minimum of 18% ± 3%. Immediately after the harvest, 10 mL/kg of homologous packed red blood cells was transfused, increasing Hct to 25% ± 3%. Oxygen saturation in the superior caval vein (Scvo2) decreased from 79% ± 4% before the harvest to 70% ± 3% (P < 0.01) at the end of it, and then increased to 74% ± 3% after the transfusion of homologous packed red blood cells. There was a strong linear correlation between mean values for Hct and Scvo2 during the various stages (r = 0.99). Mean heart rate decreased gradually during the procedure, from 106 ± 10 to 86 ± 7 beatslmin. There was no significant change in arterial pressure, but cardiac output measured by impedance cardiography was about 30% greater during harvesting than during undisturbed anesthesia. Pulse oximetric saturation was 99% or 100% throughout. Caval venous blood lactate and pyruvate concentrations remained within normal limits in all children. Recovery after anesthesia was uneventful, except in one child in whom severe shivering developed. H is concluded that the hemodilution resulted in a statistically but not clinically significant decrease in Scvo2 that was well tolerated by the patients as judged from hemodynamic responses as well as levels of arterial oxygen saturation (Sao2) and blood lactate.}}, author = {{Perez de Sá, Valéria and Békássy, Albert and Schou, Henning and Werner, Mads and Werner, Olof}}, issn = {{1526-7598}}, keywords = {{HEMODILUTION—bone marrow harvesting; ANESTHESIA; BONE MARROW HARVESTING; BLOOD}}, language = {{eng}}, number = {{5}}, pages = {{645--650}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Anesthesia and Analgesia}}, title = {{Hemodilution during bone marrow harvesting in children}}, volume = {{72}}, year = {{1991}}, }