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 2020³â 15±Ç 2È£ p.181 ~ p.186
ÇÑÀÏ»ó(Han Il-Sang) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
Á¶¿µ¿ì(Cho Young-Woo) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
¹Ú¼øÀº(Park Soon-Eun) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
¾È¹Î±â(An Min-Gi) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
°È£ÁØ(Kang Ho-June) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
À̾ƶõ(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.
Å°¿öµå
Cardiopulmonary bypass, Erythrocytosis, Hemodilution, Polycythemia, Thromboembolism
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(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.