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

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

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Orthopedic Intensive Care Unit, Liuhua Qiao Hospital, Guangzhou, People's Republic of China.


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.

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