The Use of Thoracic Fluid Content As A Guide For 6% HES Infusion during Hypervolemic Hemodilution Among Placenta Accreta Patients Undergoing Cesarean Section. A Randomized Controlled Trial

Abdullah, Sherif; Abdeltawab, Mahmoud; Youssry, Mona; Elsonbaty, Ahmed Ibrahim

doi:10.21608/ejhm.2022.252241

The Use of Thoracic Fluid Content As A Guide For 6% HES Infusion during Hypervolemic Hemodilution Among Placenta Accreta Patients Undergoing Cesarean Section. A Randomized Controlled Trial

Document Type : Original Article

Authors

department of anesthesia, Faculty of Medicine, Cairo University, Egypt

10.21608/ejhm.2022.252241

Abstract

Background: Hypervolemic hemodilution used in major surgeries is an effective method for reducing blood transfusion requirements. However, it may cause fluid overload and even pulmonary edema. Patients with placenta accreta are the focus of this study, which examines if TFC may be used as a guide for 6 percent HES infusion to minimize fluid overload.
Patients and Methods: This randomized controlled study was done on 108 patients with placenta accreta scheduled for cesarean section. They were split into two equal groups: the control group received an IV infusion of 6 percent HES at 15 ml/kg for 30 minutes before surgery for hypervolemic hemodilution and the TFC group received the same regimen but stopped if TFC =40 k ohm−1. The occurrence of pulmonary edema detected by lung ultrasound was reported. Hypoxia, total volume infused, heart rate, and mean arterial pressure were documented.
Results: A significant proportion of the control group had pulmonary edema, compared to just 1.8 percent of the TFC group. In the TFC group, hypoxia was less common, and the total volume infused was lower. U/S score was positively correlated with delta TFC and other parameters, while was negatively correlated with total fluid infused.
Conclusion: TFC was able to reduce the incidence of pulmonary edema, hypoxia, ultrasound scores, and the total infused volume. In patients undergoing significant procedures such as placenta accreta surgery, our data show that TFC is an effective guide for hypervolemic hemodilution.

Keywords