Case report: intraoperative management of extreme hemodilution in a patient with a severed axillary artery

Anesth Analg. 2010 Nov;111(5):1204-6. doi: 10.1213/ANE.0b013e3181e668b8. Epub 2010 Jun 25.


We present a case of extreme hemodilution in which appropriately crossmatched blood was not available. A 53-year-old man was admitted to our hospital because of hemorrhagic shock due to multiple stab wounds. His blood type was B, Rh negative, and his intravascular fluid volume was maintained with balanced salt solution and plasma substitutes, i.e., hydroxyethyl starch. His hemoglobin reached a nadir of 0.7 g/dL and hematocrit 2.2% before being transfused. No evidence of cardiac ischemia was noted and he was discharged in good condition. Extreme hemodilution can be successfully managed by maintaining a normal blood volume, 100% oxygen, and the use of plasma substitutes.

Publication types

  • Case Reports

MeSH terms

  • Axillary Artery / injuries
  • Axillary Artery / surgery*
  • Blood Grouping and Crossmatching
  • Blood Transfusion
  • Fluid Therapy*
  • Hematocrit
  • Hemodilution*
  • Hemoglobins / metabolism
  • Humans
  • Hydroxyethyl Starch Derivatives / administration & dosage*
  • Intraoperative Care
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy
  • Plasma Substitutes / administration & dosage*
  • Shock, Hemorrhagic / blood
  • Shock, Hemorrhagic / etiology
  • Shock, Hemorrhagic / surgery
  • Shock, Hemorrhagic / therapy*
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures*
  • Wounds, Stab / blood
  • Wounds, Stab / complications
  • Wounds, Stab / surgery
  • Wounds, Stab / therapy*


  • Hemoglobins
  • Hydroxyethyl Starch Derivatives
  • Plasma Substitutes