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CIRCULATORY REFILLING AFTER SURGERY
Author(s) -
Marshall Ver
Publication year - 1966
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1966.tb03882.x
Subject(s) - medicine , fluid replacement , blood volume , albumin , intravascular volume status , blood loss , surgery , blood transfusion , anesthesia , serum albumin , hematocrit , hemodynamics
Summary Monitoring of blood volume during surgical procedures may now be performed with considerable precision. After experimental haemorrhage of approximately one fifth of the total blood volume in man, transcapillary refilling of the circulation from interstitial fluid is brisk and results in a restored volume with a stable haemodilution after forty‐eight hours. The degree of haemoglobin or haematocrit fall is proportional to the initial blood loss. Minor or moderate surgical trauma with unreplaced loss results in a similar haemodilution. However, post‐operative extravasation into tissue planes may delay the process of haemodilution for twenty‐four hours, and the haematocrit or haemoglobin level is of no predictable clinical value in the first twenty‐four hours after surgery. Replacement of the blood lost at operation by various fluids has been studied. Whole blood replacement results in inhibition of transcapillary refilling. Electrolyte solutions such as saline have a minor and transient effect, and protein solutions markedly accelerate refilling. Isotonic protein solutions such as 5 per cent, albumin in Hartmann's solution, free of risks of transfusion reactions or of virus hepatitis, are thus of great merit in replacement of moderate blood loss during surgery. Their expense and limited availability makes investigation of synthetic volume substitutes desirable.