Haemodynamic effects of moderate normovolaemic haemodilution in conscious and anaesthetized patients

We have assessed the haemodynamic effects of moderate normovolaemic haemodilution in ASA patients, either conscious or during enflurane-fentanyl anaesthesia (10 patients in each group). Cardiac index (CI), stroke index (SI) and ejection fraction (EF) were measured by transthoracic electrical bioimpedance and, in the anaesthesia group, arterial and central venous blood samples were obtained to assess oxygen delivery (DO2), oxygen consumption (V overdot O-2) and oxygen extraction ratio (O(2)ER). In conscious patients, heart rate (HR) remained unchanged as SI, EF and CI increased. When haemodilution was performed during anaesthesia, CI remained stable in spite of a slight increase in SI, as HR decreased. This produced a reduction in DO2 which was compensated for by an increase in O(2)ER, allowing maintenance of V overdot O-2 without alteration in blood lactate concentration.