Preoperative Normovolemic Hemodilution in Aesthetic Plastic Surgery

Almeida, Marcelo Figueiredo

doi:10.1007/s002669900318

Cited by 5 publications

(2 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the steady state, p is normally 0.25-0.33 (1). However, since therapy will take place over relatively short periods of time relative to the time for intravascular volume to reach equilibrium, p should be somewhat higher in practice.…”

Section: Effect Of Infusion Volume On Hematocritmentioning

confidence: 99%

A theoretical model of selective cooling using intracarotid cold saline infusion in the human brain

Konstas¹,

Neimark²,

Laine³

et al. 2007

Journal of Applied Physiology

View full text Add to dashboard Cite

Konstas AA, Neimark MA, Laine AF, Pile-Spellman J. A theoretical model of selective cooling using intracarotid cold saline infusion in the human brain. J Appl Physiol 102: 1329 -1340, 2007. First published December 14, 2006; doi:10.1152/japplphysiol.00805.2006.-A threedimensional mathematical model was developed to examine the transient and steady-state temperature distribution in the human brain during selective brain cooling (SBC) by unilateral intracarotid freezing-cold saline infusion. To determine the combined effect of hemodilution and hypothermia from the cold saline infusion, data from studies investigating the effect of these two parameters on cerebral blood flow (CBF) were pooled, and an analytic expression describing the combined effect of the two factors was derived. The Pennes bioheat equation used the thermal properties of the different cranial layers and the effect of cold saline infusion on CBF to propagate the evolution of brain temperature. A healthy brain and a brain with stroke (ischemic core and penumbra) were modeled. CBF and metabolic rate data were reduced to simulate the core and penumbra. Simulations using different saline flow rates were performed. The results suggested that a flow rate of 30 ml/min is sufficient to induce moderate hypothermia within 10 min in the ipsilateral hemisphere. The brain with stroke cooled to lower temperatures than the healthy brain, mainly because the stroke limited the total intracarotid blood flow. Gray matter cooled twice as fast as white matter. The continuously falling hematocrit was the main time-limiting factor, restricting the SBC to a maximum of 3 h. The study demonstrated that SBC by intracarotid saline infusion is feasible in humans and may be the fastest method of hypothermia induction. therapeutic hypothermia; ischemic stroke; spatial and temporal brain temperature distributions THE CENTRAL NERVOUS SYSTEM is vulnerable to focal and global ischemia resulting from acute ischemic stroke (63) and cardiac arrest (21). Therapeutic hypothermia has been repeatedly shown to be effective in limiting the damage of global and focal ischemia in animal models and clinical studies (6,21).In most clinical studies, hypothermia is induced by surface cooling. Although this is the simplest and most cost-effective option for inducing hypothermia (14), it has two major drawbacks. 1) Several hours are required to reach the target body core temperature. All studies report a 3-to 7-h period for cooling to 32-34°C (26, 52); however, endovascular systemic cooling may be able to accelerate the rate of cooling and improve the efficacy of hypothermia (15).2) The incidence of adverse effects, such as impaired immune function, decreased cardiac output, pneumonia, and cardiac arrhythmias/bradycardias, is high (14, 31). Selective brain cooling (SBC) without reducing body core temperature can theoretically address both problems of whole body cooling.Different methods for SBC have been reported (18). Noninvasive methods most commonly used are cooling caps and helmets. However, th...

show abstract

Section: Effect Of Infusion Volume On Hematocritmentioning

confidence: 99%

A theoretical model of selective cooling using intracarotid cold saline infusion in the human brain

Konstas¹,

Neimark²,

Laine³

et al. 2007

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…9 Also, some surgeons believe that preoperative donation results in a lower hematocrit level, and that this, combined with acute preoperative hemodilution, results in a reduction in actual blood loss intraoperatively. 10,14 Numerous studies have been published assessing the role of autologous transfusion in breast reduction; most have shown no benefit to patients. 4,5 There have been no studies published to date in the English language literature assessing the role of autologous transfusion in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction.…”

mentioning

confidence: 99%

Autologous Blood Transfusion in TRAM Breast Reconstruction:

Lennox¹,

Clugston²,

Beasley³

et al. 2004

Annals of Plastic Surgery

View full text Add to dashboard Cite

Many centers continue to use preoperative donation of autologous blood as part of their reconstructive protocol for pedicled transverse rectus abdominis musculocutaneous (TRAM) breast reconstruction, despite the lack of support for this in the English language literature. This prospective study compares 3 groups of patients undergoing reconstruction with TRAM flaps using 3 different protocols in 3 different centers. Group 1 did not donate blood preoperatively. Group 2 donated 1 to 2 U preoperatively and received their blood intraoperatively or during the early postoperative period. Group 3 did not receive their autologous blood unless they displayed symptoms of hypovolemia or anemia postoperatively. There were no statistical differences between groups in age, length of stay, or number of unilateral versus bilateral procedures. Patients who did not donate autologous blood (group 1) had statistically significantly higher preoperative and postoperative day 3 hemoglobin levels than patients in the groups that did predonate. The authors conclude that preoperative autologous donation of blood does not confer any clinical advantage to patients undergoing autologous breast reconstruction using pedicled TRAM flaps.

show abstract

Blood Loss in Liposuction Surgery

Mangubat¹,

Harbke

2006

Liposuction

View full text Add to dashboard Cite

Preoperative Normovolemic Hemodilution in Aesthetic Plastic Surgery

Cited by 5 publications

References 15 publications

A theoretical model of selective cooling using intracarotid cold saline infusion in the human brain

A theoretical model of selective cooling using intracarotid cold saline infusion in the human brain

Autologous Blood Transfusion in TRAM Breast Reconstruction:

Blood Loss in Liposuction Surgery

Contact Info

Product

Resources

About