Objective: To investigate the changes in high-sensitivity C-reactive protein (hs-CRP) levels following acute hypervolemic hemodilution (AHH) in patients undergoing spinal surgery and assess the safety of AHH in terms of postoperative infection.
Methods: Forty patients undergoing spinal operation were randomly assigned into observation group and control group (n=20). Each patient was infused 4 ml/kg/h lactated Ringers solution for maintenance of the total blood volume, and in the observation group, the patients received additional infusion of 4% gelofusine solution at the rate of 20 ml/kg/h 30 min before the operation. Venous blood samples were collected to monitor the hematocrit (Hct), prothrombin time (PT), activated partial thromboplastin time (APTT) and hs-CRP before anesthesia (T0), 2 h after the beginning of the operation (T1), at the end of the operation (T2), and 24 h after the operation (T3).
Results: After AHH, Hct decreased significantly at T1 as compared with that at T0 (P<0.05) and that of the control group (P<0.01), but showed no significant difference between the two groups at T2. PT and APTT showed significant changes at T1 compared with T0 (P<0.05) but within the normal range, and were similar between the two groups at T3. hs-CRP increased significantly in the two groups at T3 compared with that at T0 (P<0.05), and a significant difference was noted between the two groups (P<0.01).
Conclusion: AHH does not affect the hemodynamics and blood coagulation of the patients undergoing spinal surgery but causes a significant elevation of hs-CRP, suggesting an increased risk of postoperative infection.