Clinical and experimental study reveals homologous-blood exchange triggers hypovolemia and hypotension during extracorporeal circulation, indicating a dose-dependent reaction to donor blood.
IT has previously been demonstrated that circulating blood volume significantly diminishes after perfusion despite careful replacement of all measured blood loss.1 Clinical and experimental evidence has developed implicating large-volume homologous-blood exchange as the cause of both the hypovolemia and the postperfusion hypotension.2 , 3 The magnitude of the volumetric and hemodynamic changes appears to be directly related to the quantity of homologous blood infused. These changes have not been demonstrated experimentally after exchange of autologous blood.3 Separate exchange of the homologous-blood compartments (erythrocytes, plasma and buffy coat) did not eliminate the manifestations of hypotension and isotopic hypovolemia in the laboratory animal. However, . . .
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Litwak et al. (1963) studied this question.
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