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골수채취시 급성과량성 혈액희석이 혈액손실 및 이식단핵세포수에 미치는 영향
최진환,문세호,홍성진,전진영,성춘호,이지영,오수아,최정환 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.1
Background : Hypervolemic hemodilution (HHD) seems to be a good alternative to acute normovolemic hemodilution to reduce transfusion requirements because it requires Bess time and effort. In a prospective study in healthy donors, we studied the effects of HHD on blood loss and menonuclear cell counts of aspirated bone marrow which were transplanted. Methods : After induction of anesthesia and positioning to prone, donors of the HHD group (n = 25) were administered 7.5 ml/kg of pentastarch and the same amount of Hartmanns solution prior to aspiration, but those of the control group (n = 25) were administered only 2 ml/kg/h of Hartmann's solution, Bone marrow was aspinted at the iliac spine and blood loss was replaced with pentastarch and Hartmann's solution for both groups. Hemoglobins and mononuclear were counted after induction, after hemodilution and the end of aspiration. Hemoglobins and mononuclear cell counts of aspirated bone marrow were also counted. Results: HHD decreased hemoglobin from 13.2 ± 1. g/dl to 10.7 ± 1.0 g/dl significantly (P $lt; 0.01). Even though hemoglobins of both groups at the end of aspiration were not different (9.3 ± 2.1 g/dl at control vs 9.5±1.1 g/dl at HHD), caloulated b]ooh loss based on body weight through aspirated bone marrrow was less in the HHD group (18.0±1,8% at control vs 16.3±2.0% at HHD, P $lt; 0.05). There was no difference in counted mononuclear cell counts between the two groups (1.8 ±0.7×10(7)/m1 at control vs 1.8 ± 0.7 × 10(7)/ml at HHD). Conclusions : During bone marrow harvesting in healthy donors, HHD reduced blood loss through aspirated bone marrow, but does not affect transplanted bone marrow mononuclear cell counts. (Korean J Anesthesial 2000; 38: 25∼29)