Acute normovolemic hemodilution for a patient with secondary polycythemia undergoing aortic valve replacement due to severe aortic stenosis - A case report -

Anesthesia and Pain Medicine 2020년 15권 2호 p.181 ~ p.186

한일상(Han Il-Sang) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
조영우(Cho Young-Woo) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
박순은(Park Soon-Eun) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
안민기(An Min-Gi) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
강호준(Kang Ho-June) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
이아란(Lee A-Ran) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine

Abstract

Background: A high hematocrit level in patients with erythrocytosis is linked with increased blood viscosity and increased risk of thromboembolism. Therefore, it is necessary to adequately lower the hematocrit level before performing a high-risk surgery.

Case: A 67-year-old male was scheduled for aortic valve replacement due to severe aortic stenosis. The preoperative hematocrit level of this patient was very high due to secondary polycythemia by hypoxia. We decided to perform acute normovolemic hemodilution after anesthetic induction to reduce the risk of thromboembolism in the patient. The patient was discharged after a successful surgery and a post-operative period without any side effects.

Conclusions: We estimate that patients with secondary polycythemia may benefit from acute normovolemic hemodilution to reduce their hematocrit levels while undergoing cardiac surgery using cardiopulmonary bypass. However, it is necessary to control the hematocrit level, since a significant decrease can cause side effects.

키워드

Cardiopulmonary bypass, Erythrocytosis, Hemodilution, Polycythemia, Thromboembolism
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주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Acute normovolemic hemodilution can be a good alternative for patients presenting severe aortic stenosis with secondary polycythemia and undergoing valve replacement that are not eligible for phlebotomy due to time constraints or their physiological conditions.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드