Safe and Effective Blood Preservation Through Acute Normovolemic Hemodilution and Low-Dose Tranexamic Acid in Open Partial Hepatectomy.

Objective: In this study, we evaluated the efficacy of tranexamic acid (TXA) and acute normovolemic hemodilution (ANH) with 6% hydroxyethyl starch (130/0.4) in minimizing blood loss during open partial liver resection. Coagulation function was assessed using thromboelastography (TEG) and hemostasis tests, while renal function changes were tracked through serum creatinine values post-surgery. Methods: Thirty patients undergoing open partial liver resection were allocated to two groups: Group T received TXA + ANH, and Group A received ANH alone. Blood was drawn from the radial artery under general anesthesia. Both groups received peripheral vein injections of 6% hydroxyethyl starch 130/0.4. Group T additionally received intravenous TXA. Primary outcomes included blood loss and allogeneic blood transfusions. TEG assessed coagulation status and renal function was monitored. Results: Group T demonstrated superior outcomes compared to Group A. Group T had significantly lower intraoperative blood loss (700 mL vs 1200 mL) and a lower bleeding rate per kilogram of body weight (13.3 mL/kg vs 20.4 mL/kg). Coagulation parameters favored Group T, with higher TEG maximum amplitude (55.91 mm vs 45.88 mm) and lower activated partial thromboplastin time (38.04 seconds vs 41.49 seconds). Neither group experienced acute renal injury or kidney function deficiency during hospitalization. Conclusion: TXA and ANH in a small dose during liver resection stabilize clotting, reduce blood loss by 6% compared to hydroxyethyl starch 130/0.4, and do not affect renal function.

Influence of Pre-Stress Magnitude on Fatigue Crack Growth Behavior of Al-Alloy.

From tensile overload to shot peening, there have been many attempts to extend the fatigue properties of metals. A key challenge with the cold work processes is that it is hard to avoid generation of harmful effects (e.g., the increase of surface roughness caused by shot peening). Pre-stress has a positive effect on improving the fatigue property of metals, and it is expected to strength Al-alloy without introducing adverse factors. Four pre-stresses ranged from 120 to 183 MPa were incorporated in four cracked extended-compact tension specimens by application of different load based on the measured stress⁻strain curve. Fatigue crack growth behavior and fractured characteristic of the pre-stressed specimens were investigated systematically and were compared with those of an as-received specimen. The results show that the pre-stress ranged from 120 to 183 MPa significantly improved the fatigue resistance of Al-alloy by comparison with that of the as-received specimen. With increasing pre-stress, the fatigue life first increases, then decrease, and the specimen with pre-stress of 158 MPa has the longest fatigue life. For the manner of pre-stress, no adverse factor was observed for increasing fatigue property, and the induced pre-stress reduced gradually till to disappear during subsequent fatigue cycling.