الفهرس 
blood transfusionOnly 14 pages are availabe for public view
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Abstract
This prospective , randomized study was designed to evaluate the efficacy and the effect of acute normovolemic hemodilution(ANH) on cerebral hemodynamics, metabolism and oxygenation profile during brain tumours resection. This study was carried out on 40 patients of either sex with an age ranging from 20 to 60 years. Patients were admitted at department of neurosurgery in Mansoura University Hospital and subjected to elective resection of brain tumors. Patients were classified into 2 equal groups; hemodilution (H group)and non hemodilution or control(C group)group. . Anesthesia was induced in all patients using thiopental sodium (5-7 mg/kg) . Tracheal intubation with appropriate sized cuffed endotracheal tube is facilitated by the use of 0.5 mg/kg atracurium. Anesthesia was maintained using isofluorane 1%. O2:air =1 :1 and atracurium for muscle relaxation . In (H) group two units of autologous blood was withdrawn from anticubital vein into blood collection bags. Hemodynamics and O2 parameters were monitored immediately before start of hemodilution then every 10 min up to the end of hemodilution , thereafter every 30 min up to the end surgery. Cerebral metabolic rate for oxygen (CMRO2), Cerebral oxygen extraction (CEO2) , Cerebral blood flow equivalent (CBFe) and Arterio-Jugular lactate difference(AJDL) were recorded at basal,40 min., end of surgery and before extubation. This clinical trial has demonstrated that ANH resulted in systemic hemodynamic (HR & MAP) stability with comparable central blood volume to the control group. ANH was associated with comparable hematologic parameters (Hb & Hct) with no significant increase in blood loss. There was no change in seum electrolytes (Na+ & K+) , plasma osmolarity or brain relaxation score. Furthermore, ANH resulted in significant increase in cerebral blood flow, no effect on cerebral metabolism as indicated by comparable effects on cerebral oxygen extraction, jugular venous oxygen saturation and arterio-jugular oxygen content difference ANH can be safely and effectively adopted in craniotomy for brain tumors resection, with comparable sequences to allogenic blood transfusion .