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Anaesthesia and circulating blood volume

Published online by Cambridge University Press:  29 April 2005

Y. Sano ,
A. Sakamoto ,
Y. Oi  and
R. Ogawa
Y. Sano
Affiliation:
Nippon Medical School, Department of Anaesthesiology, Tokyo, Japan
A. Sakamoto
Affiliation:
Nippon Medical School, Department of Anaesthesiology, Tokyo, Japan
Y. Oi
Affiliation:
Nihon University School of Dentistry, Department of Anaesthesiology, Tokyo, Japan
R. Ogawa
Affiliation:
Nippon Medical School, Department of Anaesthesiology, Tokyo, Japan
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Abstract

Summary

Background and objective: The exact change in circulating blood volume (BV) during general anaesthesia is still unknown because there is no standard method of evaluating BV. We evaluated the changes in BV by general anaesthesia using simple and easy estimation methods.

Methods: Fourteen patients scheduled for minor surgery under general anaesthesia were enrolled. Propofol and vecuronium bromide were used for the induction of anaesthesia, and anaesthesia was maintained with sevoflurane and nitrous oxide. Haematocrit (Hct), total protein concentration (TP), as well as colloid osmotic pressure (COP) measured using a colloid osmometer, were determined before anaesthesia, and 30, 60 and 90 min after the induction of general anaesthesia. BV was calculated using Allen's formula and the changes in Hct, TP and COP. The estimated BV was compared with directly measured BV using indocyanine green dilution method (BVICG).

Results: Hct, TP and COP significantly decreased after the induction of anaesthesia (Hct: 42.1–39.4%; TP: 7.3–6.9 g dL−1; COP: 23–19 mmHg). The calculated BV as well as BVICG significantly increased after induction of anaesthesia (calculated by COP: 4.13–5.03 L; BVICG: 4.54–5.56 L). The change rate in BV calculated by the change of COP was larger than other calculated BVs, and was approximated to the change rate in BVICG. After emergence from anaesthesia, all values tended to return to baseline.

Conclusions: General anaesthesia increases BV. The value of BV calculated from the change in COP was most changeable.

Keywords

GENERAL ANAESTHESIACIRCULATING BLOOD VOLUMECOLLOID OSMOTIC PRESSURE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 4 , April 2005 , pp. 258 - 262
Copyright
2005 European Society of Anaesthesiology

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References

Orth VH, Rehm M, Haller M, Thiel M, Finsterer U. The measurement of blood volume – state-of-the-art. Anaesthesist 2001; 50: 562–568.Google Scholar
Rehm M, Orth V, Kreimeier U, et al. Changes in intravascular volume during acute normovolemic hemodilution and intraoperative retransfusion in patients with radical hysterectomy. Anesthesiology 2000; 92: 657–664.Google Scholar
Armstrong DJ, Finlayson DC. The effect of spinal anaesthesia on blood volume in man. Can Anaesth Soc J 1967; 14: 399–406.Google Scholar
Rehm M, Haller M, Orth V, et al. Changes in blood volume and hematocrit during acute preoperative volume loading with 5% albumin or 6% hetastarch solutions in patients before radical hysterectomy. Anesthesiology 2001; 95: 849–856.Google Scholar
Pearson TC, Guthrie DL, Simpson J, et al. Interpretation of measured red cell mass and plasma volume in adults: Expert Panel on Radionuclides of the International Council for Standardization in Haematology. Br J Haematol 1995; 89: 748–756.Google Scholar
Veillon C, Patterson KY, Nagey DA, Tehan AM. Measurement of blood volume with an enriched stable isotope of chromium (53Cr) and isotope dilution by combined gas chromatography-mass spectrometry. Clin Chem 1994; 40: 71–73.Google Scholar
Hahn RG. Haemoglobin dilution from epidural-induced hypotension with and without fluid loading. Acta Anaesthesiol Scand 1992; 36: 241–244.Google Scholar
Freedman M. A new indicator dilution method for the estimation of surgical blood loss. Anaesthesia 1984; 39: 826–831.Google Scholar
Jones JG, Wardrop CA. Measurement of blood volume in surgical and intensive care practice. Br J Anaesth 2000; 84: 226–235.Google Scholar
Hahn RG. Blood volume at the onset of hypotension during TURP performed under epidural anaesthesia. Eur J Anaesthesiol 1993; 10: 219–225.Google Scholar
Hahn RG. Estimating allowable blood loss with correction for variations in blood volume. Acta Anaesthesiol Scand 1989; 33: 508–512.Google Scholar
Ishihara H, Okawa H, Iwakawa T, et al. Does indocyanine green accurately measure plasma volume early after cardiac surgery? Anesth Analg 2002; 94: 781–786.Google Scholar
Ishihara H, Matsui A, Muraoka M, et al. Detection of capillary protein leakage by indocyanine green and glucose dilutions in septic patients. Crit Care Med 2000; 28: 620–626.Google Scholar
Haruna M, Kumon K, Yahagi N, et al. Blood volume measurement at the bedside using ICG pulse spectrophotometry. Anesthesiology 1998; 89: 1322–1328.Google Scholar
Haller M, Akbulut C, Brechtelsbauer H, et al. Determination of plasma volume with indocyanine green in man. Life Sci 1993; 53: 1597–1604.Google Scholar
Haller M, Brechtelsbauer H, Finsterer U, et al. The determination of plasma volume using indocyanine green in man. Anaesthesist 1992; 41: 115–120.Google Scholar
Fox IJ, Brooker LG, Heseltine DW, Essex HE, Wood EH. A tricarbocyanine dye for continuous recording of dilution curves in whole blood independent of variations in blood oxygen saturation. Mayo Clin Proc 1957; 32: 478–484.Google Scholar
Allen TH, Peng MT, Chen KP, et al. Prediction of blood volume and adiposity in man from body weight and cube of height. Metabolism 1956; 5: 328–345.Google Scholar
Webster HL. Colloid osmotic pressure: theoretical aspects and background. Clin Perinatol 1982; 9: 505–521.Google Scholar
Iijima T, Takagi T, Iwao Y. An increased circulating blood volume dose not prevent hypotension after pheochromocytoma resection. Can J Anaesth 2004; 51: 212–215.Google Scholar
American Society of Anesthesiologists Task Force on Blood Component Therapy. Practice guidelines for blood component therapy: a report by the American Society of Anesthesiologists Task Force on Blood Component Therapy. Anesthesiology 1996; 84: 732–747.
Bourke DL, Smith TC. Estimating allowable hemodilution. Anesthesiology 1974; 41: 609–612.Google Scholar
Baron JF, Delayance S. Threshold values of colloid-osmotic pressure, serum albumin or protein during perioperative period. Ann Fr Anesth Reanim 1996; 15: 447–455.Google Scholar
Blackwell MM, Riley J, McCall M, Ecklund J, Southworth R. An evaluation of three methods for determining colloid osmotic pressure. J Extra Corpor Technol 1994; 26: 18–22.Google Scholar
Retzke U, Graf H. The colloid osmotic pressure of blood. Physiology, measuring technique and pre-analytic factors of influence. Zentralbl Gynakol 1991; 113: 1005–1014.Google Scholar
Carlson RW, Schaeffer JrRC, Michaels SG, Weil MH. Pulmonary edema fluid. Spectrum of features in 37 patients. Circulation 1979; 60: 1161–1169.Google Scholar
Hu X, Weinbaum S. A new view of Starling's hypothesis at the microstructural level. Microvasc Res 1999; 58: 281–304.Google Scholar
Kimura G, Van Stone JC, Bauer JH. Model prediction of plasma volume change induced by hemodialysis. J Lab Clin Med 1984; 104: 932–938.Google Scholar
Johnson HD. Fluid exchanges through capillary walls: a modification of the Starling hypothesis. Med Hypotheses 1976; 2: 147–149.Google Scholar