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J Appl Physiol 86: 860-866, 1999;
8750-7587/99 $5.00
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Vol. 86, Issue 3, 860-866, March 1999

Effect of acute normovolemic hemodilution on distribution of blood flow and tissue oxygenation in dog skeletal muscle

Jörg Hutter1, Oliver Habler1,2, Martin Kleen2, Matthias Tiede1, Armin Podtschaske1, Gregor Kemming2, Carlos Corso1, Sanjay Batra3, Peter Keipert3, Simon Faithfull3, and Konrad Messmer1

1 Institute for Surgical Research and 2 Institute of Anesthesiology, Klinikum Grosshadern, University of Munich, 81366 Munich, Germany; and 3 Alliance Pharmaceutical Corporation, San Diego, California 92121

Acute normovolemic hemodilution (ANH) is efficient in reducing allogenic blood transfusion needs during elective surgery. Tissue oxygenation is maintained by increased cardiac output and oxygen extraction and, presumably, a more homogeneous tissue perfusion. The aim of this study was to investigate blood flow distribution and oxygenation of skeletal muscle. ANH from hematocrit of 36 ± 3 to 20 ± 1% was performed in 22 splenectomized, anesthetized beagles (17 analyzed) ventilated with room air. Normovolemia was confirmed by measurement of blood volume. Distribution of perfusion within skeletal muscle was determined by using radioactive microspheres. Tissue oxygen partial pressure was assessed with a polarographic platinum surface electrode. Cardiac index (3.69 ± 0.79 vs. 4.79 ± 0.73 l · min-1 · m-2) and muscle perfusion (4.07 ± 0.44 vs. 5.18 ± 0.36 ml · 100 g-1 · min-1) were increased at hematocrit of 20%. Oxygen delivery to skeletal muscle was reduced to 74% of baseline values (0.64 ± 0.06 vs. 0.48 ± 0.03 ml O2 · 100 g-1 · min-1). Nevertheless, tissue PO2 was preserved (27.4 ± 1.3 vs. 29.9 ± 1.4 Torr). Heterogeneity of muscle perfusion (relative dispersion) was reduced after ANH (20.0 ± 2.2 vs. 13.9 ± 1.5%). We conclude that a more homogeneous distribution of perfusion is one mechanism for the preservation of tissue oxygenation after moderate ANH, despite reduced oxygen delivery.

heterogeneity of perfusion; oxygen transport; dog; acute normovolemic hemodilution


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