The preservation of renal function by isovolemic hemodilution during aortic operations.

ABSTRACT

PURPOSE: In an investigation of the effects of isovolemic hemodilution, 39 consecutive patients undergoing elective infrarenal aortic operation had detailed measurements of renal function, renal artery blood flow, and cardiac hemodynamics. METHODS: The patients were randomly allocated to receive acute preoperative isovolemic hemodilution to a hematocrit of 28%, with 20 patients receiving hemodilution and 19 being control subjects. RESULTS: Twelve (63%) of the control group had renal impairment, compared with only four (20% in the group receiving hemodilution (p < 0.01). Hemodilution also prevented the fall in cardiac output induced by cross-clamping (p < 0.01) and significantly reduced the need for transfusion of donor blood (p < 0.01). CONCLUSIONS: Acute isovolemic hemodilution is clearly a useful adjunct in the management of patients undergoing elective aortic operation.