Skip to content


Open Access

Cardiovascular function during acute normovolemic hemodilution (ANH) with hydroxyethyl starch or Ringer's lactate

  • AO Fraga1,
  • JOC AulerJr1,
  • MR Silva1 and
  • MR Lopes1
Critical Care20015(Suppl 3):P23

Published: 26 June 2001


IsofluraneCardiac IndexCentral Venous PressurePulmonary Vascular ResistancePulmonary Capillary Wedge Pressure


Our objective was to study the cardiovascular function in canines that underwent progressive normovolemic hemodilution using two different solutions.


Under general anesthesia using etomidate and isoflurane, and with controlled ventilation, 2 animals were submitted to progressive ANH with either hydroxyethyl starch (HES, n = 10) or Ringer's lactate (RL, n = 10) solution on a ratio of 1:1 or 1:3, respectively. A Swan-Ganz catheter, echocardiography and eletrocardiography were used in the assessment of the cardiovascular function. The hemodilution was monitored with sequential measurements (20 min) of the concentration values of hemoglobin and hematocrit, while the cardiovascular function for the different variables were studied. Data were evaluated through ANOVA (P < 0.05).


The final hemoglobin concentration for the HES was 4.0 (± 1.2)g/dl and 3.0 (± 1.0) g/dl for the RL. Heart rate and blood pressure did not change. The cardiac output and cardiac index increased in both groups during the hemodilution procedure; however, the RL group data had a lower value than was statistically significant at the end of the study period. The systemic and pulmonary vascular resistance decreased in both groups. The pulmonary capillary wedge pressure and central venous pressure reached higher values in both groups during ANH.


The study demonstrated that the cardiovascular variables deteriorated along with the reduction hemoglobin; nevertheless, the echocardiography data obtained would suggest that the use of HES allowed better cardiac contractility during prolonged periods of time over in lower levels of hemoglobin.

Authors’ Affiliations

Department of Anesthesia, Heart Institute, InCor, Hospital of Clinical University of São Paulo, São Paulo, Brazil


  1. Linden PV, Schmartz D, Grote FD: Critical hemoglobin concentration in anaesthetized canines: comparison of two plasma substitutes. Br J Anaesthesia. 1989, 81: 556-562.View ArticleGoogle Scholar
  2. Gillon J: Controversies in transfusion medicine: acute normovolemic hemodilution in elective major surgery-con. Transfusion. 1994, 34: 269-271. 10.1046/j.1537-2995.1994.34394196629.x.View ArticlePubMedGoogle Scholar


© The Author(s) 2001