Tolerance to perioperative anemia. Mechanisms, influencing factors and limits;Perioperative anämietoleranz. Mechanismen, einflussfaktoren, grenzen

Anaesthesist

Volumn 55, Issue 11, 2006, Pages 1142-1156

  Habler, O ^a   Meier, J ^b   Pape, A ^b   Kertscho, H ^b   Zwissler B ^b  

^a KRANKENHAUS NORDWEST   (Germany)

^b UNIVERSITY HOSPITAL FRANKFURT   (Germany)

Author keywords

Allogeneic transfusion; Anemia tolerance; Perioperative anemia; Transfusion trigger

Indexed keywords

ANEMIA; BLEEDING; BLOOD TRANSFUSION; CRITICALLY ILL PATIENT; ERYTHROCYTE TRANSFUSION; HEMOGLOBIN DETERMINATION; HUMAN; INTRAOPERATIVE PERIOD; MULTIPLE TRAUMA; REVIEW; SURGICAL PATIENT; TREATMENT INDICATION;

ANEMIA; BLOOD LOSS, SURGICAL; BLOOD PRESSURE; BLOOD SUBSTITUTES; BLOOD TRANSFUSION; HUMANS; OXYGEN CONSUMPTION; PERIOPERATIVE CARE;

EID: 33845438558     PISSN: 00032417     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00101-006-1055-y     Document Type: Review

References (120)

1. Aly Hassan A, Lochbuehler H, Frey L, Messmer K (1997) Global tissue oxygenation during normovolaemic haemodilution in young children. Paediatr Anaesth 7: 197-204
2. ASA Task Force on Blood Component Therapy (1996) Practice guidelines for blood component therapy. Anesthesiology 84: 732-747
3. Bakker J, Coffernils M, Leon M et al. (1991) Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest 99: 956-962
4. Bernek S, Biscoping J (2006) Risiken und Alternativen der Transfusion. Anaesthesiol Intensivmed 47: 143-155
5. Bommel J van, Trouwborst A, Schwarte L et al. (2002) Intestinal and cerebral oxygenation during severe isovolemic hemodilution and subsequent hyperoxic ventilation in a pig model. Anesthesiology 97: 660-670
6. Bryson GL, Laupacis A, Wells GA, for the International Study of Perioperative Transfusion (1998) Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A meta-analysis. Anesth Analg 86: 9-15
7. Busch ORC, Hop WCJ, Hoynck van Papendrecht MAW et al. (1993) Blood transfusion and prognosis in colorectal cancer. N Engl J Med 328: 1372-1376
8. Cain SM (1977) Oxygen delivery and uptake in dogs during anemic and hypoxic hypoxia. J Appl Physiol 42: 228-234
9. Carson JL, Duff A, Poses RM et al. (1996) Effect of anaemia and cardiovascular disease on surgical mortality and morbidity. Lancet 348: 1055-1060
10. Carson JL, Duff A, Berlin JA et al. (1998) Perioperative blood transfusion and postoperative mortality. JAMA 279: 199-205
11. Carson JL, Noveck H, Berlin JA, Gould SA (2002) Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion. Transfusion 42: 812-818
12. College of American Pathologists (1998) Practice parameter for the use of red blood cell transfusions. Arch Pathol Lab Med 122: 130-138
13. Delpapa EH, Edelstone DI, Milley JR, Balsan M (1992) Effects of chronic maternal anemia on systemic and uteroplacental oxygenation in near-term pregnant sheep. Am J Obstet Gynecol 166: 1007-1012
14. Edelstone DI, Paulone ME, Maljovec JJ, Hagberg M (1987) Effects of maternal anemia on cardiac output, systemic oxygen consumption, and regional blood flow in pregnant sheep. Am J Obstet Gynecol 156: 740-748
15. Falke K, Bloos F (2005) The value of venous oximetry. Curr Opin Crit Care 11: 259-263
16. Filho IPT, Spiess BD, Pittman RN et al. (2005) Experimental analysis of critical oxygen delivery. Am J Physiol 288: H1071-1079
17. Fontana JL, Welborn L, Mongan PD et al. (1995) Oxygen consumption and cardiovascular function in children during profound intraoperative normovolemic hemodilution. Anesth Analg 80: 219-225
18. Freeman GL, Little WC, O'Rourke RA (1987) Influence of heart rate on left ventricular performance in conscious dogs. Circ Res 61: 455-464
19. Freischlag JA (2004) Intraoperative blood salvage in vascular surgery - Worth the effort? Crit Care Med 8 [Suppl 2]: S53-56
20. Galati A, Greco G, Goletta C et al. (1996) Usefulness of dipyridamole transesophageal echocardiography in the evaluation of myocardial ischemia and coronary artery flow. Int J Card Imaging 12: 169-178
21. Geha AS, Baue AE (1978) Graded coronary stenosis and coronary flow during acute normovolemic anemia. World J Surg 2: 645-652
22. Gianrossi R, Detrano R, Mulvihill D et al. (1989) Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation 80: 87-98
23. Gombotz H (2003) Physiologische Grenzen der Verdünnungsanämie bei Intensivpatienten. J Anaesth Intensivbehandl 1: 84-87
24. Goodnough LT, Shander A, Brecher ME (2003) Transfusion medicine: looking to the future. Lancet 361: 161-169
25. Grange CS, Douglas J, Adams TJ, Wadsworth LD (1998) The use of acute hemodilution in parturients undergoing caesarean section. Am J Obstet Gynecol 178: 156-160
26. Habler O, Kleen M, Podtschaske A et al. (1996) The effect of acute normovolemic hemodilution (ANH) on myocardial contractility in anesthetized dogs. Anesth Analg 83: 451-458
27. Habler O, Kleen M, Hutter J et al. (1997) Effects of hemodilution on splanchnic perfusion and hepatorenal function. II. Renal perfusion and hepatorenal function. Eur J Med Res 2: 419-424
28. Habler OP, Kleen M, Hutter J et al. (1998) Iv perflubron emulsion versus autologous transfusion in severe normovolemic anemia: effects on left ventricular perfusion and function. Res Exp Med 197: 301-318
29. Habler OP, Kleen MS, Hutter JW et al. (1998) Effects of hyperoxic ventilation on hemodilution-induced changes in anesthetized dogs. Transfusion 38: 135-144
30. Habler OP, Kleen MS, Hutter JW et al. (1998) Hemodilution and iv perflubron emulsion as an alternative to blood transfusion: effects on tissue oxygenation during profound hemodilution in anesthetized dogs. Transfusion 38: 145-155
31. Habler O, Kleen M, Podtschaske A et al. (2000) Akute normovolämische Hämodilution (ANH). Effekte der ANH auf die diastolische Funktion des linken Ventrikels. Anaesthesist 49: 939-948
32. Habler O, Meier J, Pape A, Zwißler B (2004) Indikation zur Bluttransfusion bei orthopädischen Eingriffen. Orthopade 33: 774-783
33. Habler O, Schwenzer K, Zimmer K et al. (2004) Effects of standardized acute normovolemic hemodilution on intraoperative allogeneic blood transfusion in patients undergoing major maxillofacial surgery. Int J Oral Maxillofac Surg 33: 467-475
34. Habler O, Pape A, Meier J, Zwißler B (2005) Künstliche Sauerstoffträger als Alternative zur Bluttransfusion. Anaesthesist 54: 741-754
35. Hagl S, Heimisch W, Meisner H et al. (1974) The effect of hemodilution on regional myocardial function in the presence of coronary stenosis. Basic Res Cardiol 72: 344-364
36. Haisjackl M, Luz G, Sparr H et al. (1997) The effects of progressive anemia on jejunal mucosal and serosal tissue oxygenation in pigs. Anesth Analg 84: 538-544
37. Hallowell P, Bland JHL, Chir B et al. (1972) Transfusion of fresh autologous blood in open-heart surgery. J Thorac Cardiovasc Surg 64: 941-948
38. Halm EA, Wang JJ, Bookvar K et al. (2003) Effects of blood transfusion on clinical and functional outcomes in patients with hip-fracture. Transfusion 43: 1358-1365
39. Hansen E, Knuechel R, Altmeppen J, Taeger K (1999) Blood irradiation for intraoperative autotransfusion in cancer surgery: demonstration of efficient elimination of contaminating tumor cells. Transfusion 39: 608-615
40. Hardy J-F, Moerloose P, Samama M (2004) Massive transfusion and coagulopathy: pathophysiology and implications for clinical management. Can J Anesth 51: 293-310
41. Hebert PC, Wells G, Blajchman MA et al. (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340: 409-417
42. Hebert PC, Blajchman MA, Cook DJ et al. (2001) Do blood transfusions improve outcomes related to mechanical ventilation? Chest 119: 1850-1857
43. Heiss MM, Mempel W, Jauch K-W et al. (1993) Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery. Lancet 342: 1328-1333
44. Horwich TB, Fonarow GC, Hamilton MA et al. (2002) Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. J Am Coll Cardiol 39: 1780-1786
45. Jan K-M, Chien S (1977) Effect of hematocrit variations on coronary hemodynamics and oxygen utilization. Am J Physiol 2: H106-113
46. Johnson RG, Thurer RL, Kruskall MS et al. (1992) Comparison of two transfusion strategies after elective operations for myocardial revascularization. J Thorac Cardiovasc Surg 104: 307-314
47. Karger R, Kretschmer V, Wulf H (2004) Risiken der Transfusion von Blutkomponenten: aktuelle Anhaltszahlen für eine "quantitative" Risikoaufklärung. Anaesthesiol Intensivmed 45: 430-434
48. 2-supply-dependency. Eur J Med Res 7: 139-148
49. Kemming GI, Meisner FG, Kleen M et al. (2003) Hyperoxic ventilation at the critical hematocrit. Resuscitation 56: 289-297
50. 2 transport and tissue oxygenation. Transfus Altern Transfus Med 5: 523-529
51. Kemming GI, Meisner FG, Meier J et al. (2004) Hyperoxic ventilation at the critical hematocrit: effects on myocardial perfusion and function. Acta Anaesth Scand 48: 951-959
52. Kleen M, Habler O, Hutter J et al. (1996) Effects of hemodilution on gastric regional perfusion and intramucosal pH. Am J Physiol 271: H1849-1855
53. Kleen M, Habler O, Hutter J et al. (1997) Effects of hemodilution on splanchnic perfusion and hepatorenal function. Part I: splanchnic perfusion. Eur J Med Res 2: 413-418
54. Koch CG, Li L, Duncan AI et al. (2006) Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting. Crit Care Med 34: 1608-1616
55. Leung JM, Weiskopf RB, Feiner J et al. (2000) Electrocardiographic ST-segment changes during acute, severe isovolemic hemodilution in humans. Anesthesiology 93: 1004-1010
56. Levy PS, Kim SJ, Eckel PK et al. (1993) Limit to cardiac compensation during acute normovolemic hemodilution: influence of coronary stenosis. Am J Physiol 265: H340-349
57. Lichtenstein A, Eckhart WF, Swanson KJ et al. (1988) Unplanned intraoperative and postoperative hemodilution: oxygen transport and consumption during severe anemia. Anesthesiology 69: 119-122
58. Licker M, Ellenberger C, Murith N et al. (2004) Cardiovascular response to acute normovolemic haemodilution in patients with severe aortic stenosis: assessment with transoesophageal echocardiography. Anaesthesia 59: 1170-1177
59. Licker M, Ellenberger C, Sierra C et al. (2005) Cardiovascular response to acute normovolemic hemodilution in patients with coronary artery disease: assessment with transoesophageal echocardiography. Crit Care Med 33: 591-597
60. Licker M, Mariethoz E, Jorge Costa M, Morel D (2005) Cardioprotective effects of acute isovolemic hemodilution in a rat model of transient coronary occlusion. Crit Care Med 33: 2302-2308
61. -1. Anesthesiology 92: 407-413
62. 2 delivery. J Appl Physiol 71: 83-93
63. Linden P van der, Schmartz D, Groote F de et al. (1998) Critical hemoglobin concentration in anesthetized dogs: comparison of two plasma substitutes. Br J Anaesth 81: 556-562
64. Linden P van der, Schmartz D, Gilbart E et al. (2000) Effects of propofol, etomidate and pentobarbital on critical oxygen delivery. Crit Care Med 28: 2492-2499
65. Linden P van der, Hert S de, Mathieu N et al. (2003) Tolerance to acute isovolemic hemodilution. Effect of anesthetic depth. Anesthesiology 99: 97-104
66. Lipsic E, Horst ICC van der, Voors AA et al. (2005) Hemolobin levels and 30-day mortality in patients after myocardial infarction. Int J Cardiol 100: 289-292
67. Marik PE, Sibbald WJ (1993) Effects of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 269: 3024-3029
68. Matot I, Scheinin O, Jurim O, Eid A (2002) Effectiveness of acute normovolemic hemodilution to minimize allogeneic blood transfusion in major liver resections. Anesthesiology 97: 794-800
69. McIntyre L, Hebert PC, Wells G et al. (2004) Is a restrictive transfusion strategy safe for resuscitated and critically ill trauma patients? J Trauma 57: 563-568
70. Meier J, Wölkhammer S, Habler O (2003) The DeltaCrit system (DCS): a computer program for standardized bedside detection of critical oxygen delivery using the Deltatrac II™ metabolic monitor. Comp Biol Med 33: 395-405
71. Meier J, Kemming GI, Kisch-Wedel H et al. (2004) Hyperoxic ventilation reduces 6-hour mortality at the critical hemoglobin concentration. Anesthesiology 100: 70-76
72. Meier J, Pape A, Kleen M et al. (2005) Regional blood flow during hyperoxic haemodilution. Clin Physiol Funct Imaging 25: 158-165
73. Meier J, Kemming G, Meisner F et al. (2005) Hyperoxic ventilation enables hemodilution beyond the critical myocardial hemoglobin concentration. Eur J Med Res 10: 462-468
74. Meier J, Pape A, Loniewska D et al. (2006) Einfluss von Noradrenalin auf die akute Anämietoleranz. Anaesthesiol Intensivmed (in press)
75. Meisner FG, Kemming GI, Habler OP et al. (2001) Diaspirin crosslinked hemoglobin enables extreme hemodilution beyond the critical hematocrit. Crit Care Med 29: 829-838
76. Monk TG, Goodnough LT, Brecher ME et al. (1997) Acute normovolemic hemodilution can replace preoperative autologous blood donation as a standard of care for autologous blood procurement in radical prostatectomy. Anesth Analg 85: 953-958
77. Morimoto Y, Mathru M, Martinez-Tica JF, Zornow MH (2001) Effects of profound anemia on brain tissue oxygen tension, carbon dioxide tension, and pH in rabbits. J Neurosurg Anesth 13: 33-39
78. Morita Y, Chin-Yee I, Yu P et al. (2003) Critical oxygen delivery in conscious septic rats under stagnant of anemic hypoxia. Am J Respir Crit Care Med 167: 868-872
79. Nöldge GFE, Priebe H-J, Geiger K (1992) Splanchnic hemodynamics and oxygen supply during acute normovolemic hemodilution alone and with isoflurane-induced hypotension in anesthetized pigs. Anesth Analg 75: 660-674
80. Olsfanger D, Fredman B, Goldstein B et al. (1997) Acute normovolemic haemodilution decreases postoperative allogeneic blood transfusion after total knee replacement. Br J Anaesth 79: 317-321
81. Palmieri TL, Caruso DM, Foster KN et al. (2006) Effect of blood transfusion on outcome after major burn injury: a multicenter study. Crit Care Med 34: 1602-1607
82. Pape A, Meier J, Kertscho H et al. (2006) Hyperoxic ventilation increases the tolerance of acute normovolemic anemia in anesthetized pigs. Crit Care Med 34: 1475-1482
83. Paulone ME, Edelstone DI, Shedd A (1987) Effects of maternal anemia on uteroplacental and fetal oxidative metabolism in sheep. Am J Obstet Gynecol 156: 230-237
84. Perez-de-Sa V, Roscher R, Cunha-Goncalves D et al. (2002) Mild hypothermia has minimal effects on the tolerance to severe progressive normovolemic anemia in swine. Anesthesiology 97: 1189-1197
85. Pries AR, Fritzsche A, Ley K, Gaethgens P (1992) Redistribution of red blood cell flow in microcirculatory networks by hemodilution. Circ Res 70: 1113-1121
86. Rao SV, Jollis JG, Harrington RA et al. (2004) Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes. JAMA 292: 1555-1562
87. Räsänen J (1992) Supply-dependent oxygen consumption and mixed venous oxyhemoglobin saturation during isovolemic hemodilution in pigs. Chest 101: 1121-1124
88. Rivers E, Nguyen B, Havstad S et al. (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345: 1368-1377
89. Schaller RT, Schaller J, Furman EB (1984) The advantages of hemodilution anesthesia for major liver resection in children. J Pediatr Surg 19: 705-710
90. Schönhofer B, Böhrer H, Köhler D (1998) Blood transfusion facilitating difficult weaning from the ventilator. Anaesthesia 53: 169-191
91. Schou H, Perez de Sa V, Sigurdardottir M et al. (1996) Circulatory effects of hypoxia, acute normovolemic hemodilution and their combination in anesthetized pigs. Anesthesiology 84: 1443-1454
92. Schou H, Kongstad L, Perez de Sa V et al. (1998) Uncompensated blood loss is not tolerated during acute normovolemic hemodilution in anesthetized pigs. Anesth Analg 87: 786-794
93. Segal JB, Blasco-Colmenares E, Norris EJ, Guallar E (2004) Preoperative acute normovolemic hemodilution: a meta-analysis. Transfusion 44: 632-644
94. Simchon S, Chen RYZ, Carlin RD et al. (1986) Effects of blood viscosity on plasma renin activity and renal hemodynamics. Am J Physiol 250: F40-46
95. Smith MJ, Stiefel MF, Magge S et al. (2005) Packed red blood cell transfusion increases local cerebral oxygenation. Crit Care Med 33: 1104-1108
96. Spahn DR, Zollinger A, Schlumpf RB et al. (1996) Hemodilution tolerance in elderly patients without known cardiac disease. Anesth Analg 82: 681-686
97. Spahn DR, Schmid ER, Seifert B, Pasch T (1996) Hemodilution tolerance in patients with coronary artery disease who are receiving chronic beta-adrenergic blocker therapy. Anesth Analg 82: 687-694
98. Spahn DR, Seifert B, Pasch T, Schmid ER (1998) Haemodilution tolerance in patients with mitral regurgitation. Anaesthesia 53: 20-24
99. Spahn DR, Bremt R van, Theilmeier G et al., the European Perflubron Emulsion Study Group (1999) Perflubron emulsion delays blood transfusions in orthopedic surgery. Anesthesiology 91: 1195-1208
100. Sunder-Plassmann L, Klövekorn WP, Holper K et al. (1971) The physiological significance of acutely induced hemodilution. Aalborg 1970. In: Ditzel J, Lewis D (eds) Proc. 6th Europ. Conf. Microcirculation. Karger, Basel, pp 23-28
101. Suttner S, Piper SN, Kumle B et al. (2004) The influence of allogeneic red blood cell transfusion compared with 100% oxygen ventilation on systemic oxygen transport and skeletal muscle oxygen tension after cardiac surgery. Anesth Analg 99: 2-11
102. Teßmann R, Lüpke U von (1996) Überleben einer schwersten Blutungsanämie bei einer Zeugin Jehovas. Anasthesiol Intensivmed Notfallmed Schmerzther 31: 501-504
103. Toy P, Gajic O (2004) Transfusion-related acute lung injury. Anesth Analg 99: 1623-1624
104. Trouwborst A, Tenbrinck R, Woerkens E van (1990) Blood gas analysis of mixed venous blood during normoxic acute isovolemic hemodilution in pigs. Anesth Analg 70: 523-529
105. Tsai AG, Cabrales P, Intaglietta M (2004) Microvascular perfusion upon exchange transfusion with stored red blood cells in normovolemic anemic conditions. Transfusion 44: 1626-1634
106. Vamvakas EC, Taswell HF (1994) Epidemiology of blood transfusion. Transfusion 34: 464-470
107. Vernon D, Witte M (2000) Effect of neuromuscular blockade on oxygen consumption and energy expenditure in sedated, mechanically ventilated children. Crit Care Med 28: 1569-1571
108. Viele MK, Weiskopf RB (1994) What can we learn about the need for transfusion from patients who refuse blood? The experience with Jehovah's Witnesses. Transfusion 34: 396-401
109. Vincent JL, Baron J-F, Reinhart K et al. (2002) Anemia and blood transfusion in critically ill patients. JAMA 288: 1499-1507
110. Vorstand und Wissenschaftlicher Beirat der Bundesärztekammer (2003) Erythrozytenkonzentrate - Anwendung, Dosierung, Art der Anwendung. Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten, 3. überarb. u. erw. Aufl. Deutscher Ärzteverlag, Köln, S 11-14
111. Weber EWC, Slappendel R, Prins MH et al. (2005) Perioperative blood transfusions and delayed wound healing after hip replacement surgery: effects on duration of hospitalization. Anesth Analg 100: 1416-1421
112. Weiskopf RB, Kramer JH, Viele M et al. (2000) Acute severe isovolemic anemia impairs cognitive function and memory in humans. Anesthesiology 92: 1646-1652
113. Weiskopf RB, Feiner J, Hopf HW et al. (2002) Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology 96: 871-877
114. Weiskopf RB, Aminoff MJ, Hopf HW et al. (2003) Acute isovolemic anemia does not impair peripheral or central nerve conduction. Anesthesiology 99: 546-551
115. Weiskopf RB, Feiner J, Hopf H et al. (2003) Heart rate increases linearly in response to acute isovolemic anemia. Transfusion 43: 235-240
116. Weiskopf RB, Toy P, Hopf HW et al. (2005) Acute isovolemic anemia impairs central processing as determined by P300 latency. Clin Neurophysiol 116: 1028-1032
117. Weiskopf RB, Feiner J, Hopf H (2006) Fresh blood and aged stored blood are equally efficacious in immediately reversing anemia-induced brain oxygenation deficits in humans. Anesthesiology (in press)
118. Woerkens ECSM van, Trouwborst A, Van Lanschot JJB (1992) Profound hemodilution: what is the critical level of hemodilution at which oxygen delivery-dependent oxygen consumption starts in an anesthetized human. Anesth Analg 75: 818-821
119. Wu W-C, Rathore SS, Wang Y et al. (2001) Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 345: 1230-1236
120. Zollinger A, Hager P, Singer T et al. (1997) Extreme hemodilution due to massive blood loss in tumor surgery. Anesthesiology 87: 985-987