Isovolaemic haemodilution with hydroxyethylstarch has no effect on somatosensory evoked potentials in healthy volunteers.

Abstract

An animal study in anaesthetized baboons demonstrated that somatosensory evoked potentials (SSEP) can be affected by extreme haemodilution. This might lead to misinterpretation and reduce the value of intraoperative SSEP monitoring when colloids are administered. In the present study, the effect of haemodilution (HD) and subsequent retransfusion of autologous blood on SSEP was determined in healthy non-premedicated volunteers. Acute isovolaemic HD served as a model for blood loss immediately replaced with colloids. In 12 volunteers, 20 ml/kg.bw blood was withdrawn within 30 minutes and simultaneously multaneously replaced with 6% hydroxyethylstarch (HES). 30 minutes later, the autologous blood was retransfused within 30 minutes. Recording sites and parameters were: 1. Median nerve SSEP: cortical, cervical (C2), Erb's point; 2. Posterior tibial nerve SSEP: cortical, cervical (C2), lumbar (L1). In addition to SSEP latency and amplitude, median and tibial nerve central conduction times, spinal conduction time and nerve conduction velocity were determined. Serial SSEP measurements were made before, during and after HD and retransfusion every 15 minutes. HD consisting of a withdrawal volume of 1550 +/- 155 ml (mean +/- SD) induced a decrease in haematocrit from 42.0 +/- 3.1% to 29.6 +/- 1.6% (P < 0.001). Following retransfusion, haematocrit increased to 35.0 +/- 2.1% (P < 0.001). Neither HD nor retransfusion influenced SSEP parameters. We conclude from our data that the therapy of blood loss up to 30% of estimated blood volume with HES does not affect SSEP monitoring as long as normovolaemia is maintained.