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Anemia occurs during pregnancy presumably due to the hemodilution caused by greater vascular volume, EPO resistance as a result of increased cytokine production during pregnancy, and high demand of red blood cell production for fetal growth [ 14].
The tail artery and vein were cannulated to perform the hemodilution and to monitor MAP, arterial blood gases, and Hb by co-oximetry.
The hemodilution in the present study reduced the oxygen reserve, as indicated by the decreases in systemic hematocrit to 31.6% and 26.4% for HES and PEG-albumin, respectively.
In the hemodilution group, we performed a stepwise hemodilution through isovolemic exchange of blood with 6% hydroxyethyl starch 130/0.4 in 0.9% NaCl (Voluven, Fresenius Kabi, Bad Homburg, Germany).
The hemodilution procedure took about 30 minutes.
The hemodilution procedure led to a significant decrease in the total volume of the endothelial surface layer by 240 ± 133 ml, which could not be restored by protein infusion.
The shift outward by more than 80% of the infused amount of crystalloid was completed within 30 minutes after the end of the hemodilution, being much faster than generally assumed.
No one was eliminated from the study due to intolerance of the hemodilution.
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