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British Journal of Anaesthesia, Vol 81, Issue 4 556-562, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

LABORATORY INVESTIGATIONS

Critical haemoglobin concentration in anaesthetized dogs: comparison of two plasma substitutes

P. Van der Linden, D. Schmartz, F. De Groote, N. Mathieu, P. Willaert, I. Rausin and J. L. Vincent
Department of Anaesthesia, Erasme University Hospital, Free University of Brussels, 808 route de Lennik B-1070, Brussels, Belgium; Department of Intensive Care, Erasme University Hospital, Free University of Brussels, 808 route de Lennik B-1070, Brussels, Belgium

We have explored systemic and regional tolerance to haemodilution during anaesthesia with two different synthetic colloids. Eighteen dogs undergoing mechanical ventilation during anaesthesia with ketamine were submitted to progressive normovolaemic haemodilution with either gelatin (GEL; n = 9) or hydroxyethylstarch (HES; n = 9) administered on a 1:1 ratio. Systemic oxygen delivery was calculated from measurement of thermodilution cardiac output and arterial oxygen content, while systemic oxygen consumption was determined from expired gas analysis. Mesenteric oxygen delivery and consumption were determined using ultrasonic flow measurements, and arterial and mesenteric venous oxygen contents. The critical haemoglobin concentration (i.e. the haemoglobin value below which oxygen consumption becomes oxygen delivery dependent) was mean 3.6 (SD 0.8) g dl-1 in the GEL and 3.5 (1.5) g dl-1 in the HES group. The mesenteric critical oxygen extraction ratio (O2ER) (GEL 50.1 (12.1)%; HES 48.5 (13.4)%) was significant lower than the systemic critical O2ER (GEL 66.1 (8.4)%; HES 67.7 (7.1)%). There were no significant differences between the GEL and HES groups for any of these variables, or in the amount of colloid administered. During the study, oxygen delivery decreased almost linearly with reduction in haemoglobin, indicating a lack of cardiac output response to anaemia during ketamine anaesthesia.
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