A Pattern of Blood-Volume Responses to Open-Heart Surgery

Berger, Robert L.; Boyd, Thomas F.; Marcus, Phillip S.

doi:10.1056/nejm196407092710201

Cited by 30 publications

(6 citation statements)

References 7 publications

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“…However, in the present study, in which the blood volume was studied in a serial and long-term fashion and the control group was evaluated under experimental conditions identical to those of the autotransplanted group except for transplantation, all factors other than denervation could be excluded. Consequently, our study allows us to affirm that the variations of blood volume in the first postoperative week are inherent in the surgical procedure and in extracorporeal cir culation [1,3,4,11,34] and that the hyper volemia imputable to cardiac denervation becomes manifest following the 1st postop erative week.…”

Section: Discussionmentioning

confidence: 51%

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Long-Term Daily Study of Blood Volume in Cardiac Autotransplanted Dogs

Parent¹,

Stanley²,

Chartrand³

1987

Eur Surg Res

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Cardiac transplantation is followed by the interruption of afferent nerves to the heart. Knowing that some of the afferent nerves are responsible for the homeostasis of the blood volume, we undertook a serial and long-term study of the blood volume in 25 dogs with denervated hearts. The animals were autotransplanted in order to eliminate repercussions linked to rejection and to its treatment. To discern the effects of surgery and of extracorporeal circulation from those of denervation, a group of 11 control dogs was operated upon and subjected to a period of extracorporeal circulation. In both groups, serial and long-term studies of blood volume were carried out daily with ¹³¹I-labeled albumin. Analysis of the results demonstrated that in the hours following surgery, blood volume is significantly decreased by 11 % in the control group and by 22 % in group 2. By the 5th postoperative day, the blood volume had increased gradually to attain normal values in both groups. At the 2nd postoperative week, the total blood volume remained normal in the control group, whereas blood volume had increased by 5.7% in the autotransplanted dogs, this being due to a 38% increase of the plasmatic phase. This increment persisted from the 14th to the 42nd postoperative day and attained 7.4%. Our conclusion is that the variations in blood volume during the 1st postoperative week in the autotransplanted heart are inherent in surgery and in extracorporeal circulation. Afterwards, the hypervolemia shown in the transplanted dogs is secondary to cardiac denervation.

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Section: Discussionmentioning

confidence: 51%

“…The red cell volume remained decreased in both groups due mainly to hemolysis occurring following extracorporeal circulation [ 1 ] and daily blood sampling [3].…”

Section: Discussionmentioning

confidence: 96%

Long-Term Daily Study of Blood Volume in Cardiac Autotransplanted Dogs

Parent¹,

Stanley²,

Chartrand³

1987

Eur Surg Res

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“…The maintenance of a correct blood volume after major cardiac surgery is of considerable importance as marked deviation from the normal volume can seriously impair cardiorespiratory function (Berger, Boyd, and Marcus, 1964). At Guy's Hospital it was the policy to control the blood transfusion requirements postoperatively by maintaining a high central venous pressure.…”

mentioning

confidence: 99%

Effect on blood volume of maintaining a high central venous pressure after major aortic valve surgery

Fluck

Bescós

Gilkes

1973

Thorax

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. (1973). Thorax, 28,[762][763][764][765][766][767]. Effect on blood volume of maintaining a high central venous pressure after major aortic valve surgery. Serial blood volume measurements were made in 15 patients undergoing major aortic valve surgery requiring cardiopulmonary bypass. In all patients the plasma volume was measured by iodine-125 (125I) labelled albumin and in 10 the red cell mass was measured by chromium-5 1 (51Cr) labelled red cells. Close correlation was found between the blood volume derived from the plasma volume and central venous haematocrits and the blood volume derived by addition of the plasma volume and red cell mass. Postoperatively blood was given to maintain the right atrial pressure at between 10 and 15 cm H20. Before operation the red cell mass, and plasma and blood volumes related to body weight were within the normal range. In the postoperative phase the first measurement two hours after the end of the operation showed a significant decrease in mean blood volume, red cell mass, and plasma volume as compared with the preoperative level. By the second postoperative measurement six hours after the end of operation the mean blood volume had risen to the preoperative level. Subsequently, over postoperative days 1 to 6 the mean blood volume remained steady, although the red cell mass tended to fall. After blood transfusion had ceased the red cell mass usually showed a progressive fall. It was considered that although there was little relationship between the right atrial pressure and the blood volume there was little or no clinical value in performing serial postoperative measurements of blood volume in addition to venous pressure monitoring in these patients.

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“…The use of haemodilution and plasma expanders during and after cardiopulmonary bypass introduces new factors in blood volume change (Ankeney, Renner, Leverett, and Beheler, 1965) which call for measurement. The advent of a rapid, semi-automatic system (Williams and Fine, 1961) has permitted more accurate control of replacement therapy (Berger et al, 1964;Flanagan et al, 1964); whether the method is reliable in the presence of dextran or could be used during perfusion has not been previously determined.…”

mentioning

confidence: 99%

“…A number of postoperative studies have attempted to correlate clinical determinations of blood loss with volumes estimated by tracer techniques. Discrepancies noted have been attributed to extensive haemorrhage into traumatized tissue (Flanagan, Steinmetz, Crawford, and Merendino, 1964), internal redistribution of functional extracellular fluid by plasma exudation occurring after any form of major surgery (Berger, Boyd, and Marcus, 1964), or to the homologous blood syndrome, in which there is a shift of blood from the extracorporeal circuit into the patient during perfusion and a measurable blood deficit post-operatively (Gadboys, Slonim, and Litwak, 1962;Litwak, Slonim, Wisoff, and Gadboys, 1963). One investigation showed no discrepancy in the volumes estimated by clinical and isotope methods (Theye and Kirklin, 1963).…”

mentioning

confidence: 99%

Blood volume and haemodilution in extracorporeal circulation: changes during perfusion.

Guha¹

1966

Thorax

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A Pattern of Blood-Volume Responses to Open-Heart Surgery

Cited by 30 publications

References 7 publications

Long-Term Daily Study of Blood Volume in Cardiac Autotransplanted Dogs

Long-Term Daily Study of Blood Volume in Cardiac Autotransplanted Dogs

Effect on blood volume of maintaining a high central venous pressure after major aortic valve surgery

Blood volume and haemodilution in extracorporeal circulation: changes during perfusion.

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