OPTIMAL HEMATOCRIT VALUE IN CRITICALLY ILL POST-OPERATIVE PATIENTS

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 147  (3) , 363-368
Abstract
Falling hematocrit values are traditionally used to observe the course of active bleeding, since hematocrit values usually reflect acute blood losses. Evidence from the literature suggests that, after volume replacement, some degree of normovolemic hemodilution may be desirable and that return to normal hematocrit values is not necessarily the appropriate goal of transfusion therapy. The optimal hematocrit value was defined empirically by 3 methods in a series of 94 critically ill postoperative patients. The mortality rates of postoperative patients were lowest with hematocrit values between 27-33%. Mortality rates were examined when hematocrit values and the important cardiorespiratory variables were reduced. Significantly increased mortalities occurred when hematocrit values were less than an average of 32%. Oxygen availability and oxygen consumption increased significantly after whole blood and packed red cell transfusions were given when hematocrit values were less than 32% but not above 33%. When accurate blood volume measurements are not available, hematocrit values of 32% are optimal. When volume therapy is indicated, blood may be given with hematocrit values less than 32%; crystalloids or colloids are preferred with hematocrit values greater than 32%.

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