Biochemical changes associated with the use of haemodilution with 5% dextrose in water and mannitol for open-heart surgery

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Abstract
In 26 patients studied using different degrees of hemodilution, metabolic acidosis appeared to be mainly due to the dilution of blood buffer. Changes in electrolyte balance were more marked with greater dilution. The effects on serum Na and Cl were transient. Serum K fell markedly during the post-operative phase and was associated with dysrhythmias. Variation in K concentration is due to redistribution of K between the intra-cellular and extracellular phase and to an increased urinary excretion of K. The acidosis and hypokalemia can be rapidly corrected by the administration of sodium bicarbonate and K. The changes in acid-base metabolism and electrolyte balance can possibly be prevented by suitably modifying the priming fluid.