The Effects Of Acute Hemodilution On Hepatorenal Function, Plasma H-FABP And S100β Protein Concentration In Patients Undergoing Lumbar Surgery

Objective To investigate the effects of different degrees of hemodilution on hepatorenal function, plasma H-FABP and S100β protein concentration in patients undergoing lumbar surgery.Methods Patients, ASA status I-II, aged 18-60 years, undergoing lumbar surgery between April 2015 to July 2015 were selected as researching subjects. Hemodilution was performed with Sodium Lactate Ringer’s Injection(SLRI) and Succinylated Gelatin Injection after anesthesia induction. Extensive monitoring is required in the perioperative period. The venous blood samples were taken before operation and 1 day after operation to determineliver and kidney functions,plasma S100β protein and H-FABP concentration were detected before hemodilution and 2 hours after surgery. All patients were divided into 3 groups based on the lowest hematocrit during operation:H1group(HCT>30%),H2group(25 ﹤ HCT≤30%) and H3group(20≤HCT ≤25%).Results We analyzed 218 patients, vital signs of all patients were stable.1. Compared with pre-operation, there was no significant changes of ALT 1 day after surgery(P>0.05); The ALT concentrations were not significant different among the three groups(P>0.05). Compared with pre-operation, the AST concentrations measured 1 day after surgery were significantly increased in group H1 and H2(P<0.05), though their values were still within normal range. There was no significant difference among the three groups(P>0.05).2. Compared with pre-operation, there was no significant changes of Cr 1 day after surgery(P>0.05), the Cr level was significant lower in group H3 than it in group H1(P<0.05); The BUN level was not significant different(P>0.05).3. Compared with pre-operation, the H-FABP concentrations measured 2 hours after surgery were significantly increased in all groups(P<0.05), but within normal range, there was no significant difference among the three groups(P>0.05).4. Compared with pre-operation, There was no significant changes of S100β 2 hours after surgery(P>0.05), and there was no significant difference among the three groups(P>0.05).Conclusion The study suggested that hemodilution has no obvious impact on hepatorenal function, brain and heart in healthy patients undergoing lumbar surgery when HCT is reduced to 20%.