Case series reveals preserved organ function after extreme hemodilution in surgical patients, indicating blood volume maintenance prevents major complications.
Key Points
To evaluate the clinical feasibility and physiological impact of conducting open-heart surgery without homologous blood transfusions using crystalloid replacement.
Studied 6 Jehovah's Witness patients undergoing open-heart surgery without any blood transfusions.
Primed the extracorporeal apparatus exclusively with crystalloid solutions and used crystalloids for all postoperative fluid replacement.
Performed sequential postoperative assessments of cardiac, cerebral, renal, and hepatic function for up to one week.
Severe acute reductions in red blood cell mass and absolute hematocrit produced no significant impairment of cardiac, cerebral, renal, or hepatic function up to one week postoperatively.
One operative fatality occurred, whereas the other 5 patients recovered, became ambulatory, and were successfully discharged.