Abstract:
Objective To assess the efficacy and safety of acute hypervolemic hemodilution (AHHD) targeting stroke volume variability (SVV) in reducing blood loss and transfusion volume in patients who underwent spinal tumor surgery.
Methods Forty patients with spinal tumor enrolled in Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from January 2020 to October 2021 were randomly categorized into groups A and B, 20 cases each. Patients in group A received AHHD with SVV≤7%, and those in group B received AHHD with SVV≥13%. Blood gas analysis results, regional cerebral oxygen saturation (rSO2) levels, and hemodynamic indexes at before AHHD(T0), after AHHD (T1), bleeding 500 mL (T2), bleeding 1 000 mL (T3), and 30 min after the surgery (T4) were recorded. The mini-mental state examination (MMSE) scores on the day before surgery and on days 1, 3, and 5 postoperatively were recorded.
Results There was no significant difference in blood loss volume between both the groups (P>0.05). During surgery, total infusion volume and urine volume were higher in group A than in group B, and blood transfusion volume and rate were lower in group A than in group B (P<0.05). Compared with group A, the heart rate (HR) and lactate level increased and mean arterial pressure (MAP) and rSO2 decreased in group B at T3 (P<0.05). The MMSE scores on day 1 postoperatively were lower in group B than in group A, and the incidence of cognitive dysfunction was higher in group B than in group A (P<0.05).
Conclusions Target-oriented AHHD with SVV≤7% can decrease the blood transfusion volume and rate during spinal tumor surgery, stabilize hemodynamics, and reduce the incidence of postoperative cognitive dysfunction.