Abstract
We applied intraoperative continuous hemofiltration to a 37-year-old male patient with severe hemodilution (Hb<2g•dl-1) due to unexpected massive bleeding (4, 500g) and supplemental infusion. The patient had been suffering from chronic renal failure, and underwent cadaver kidney transplantation. On the 16th postoperative day, abdominal echo and CT revealed thrombosis in the common iliac vein. Initially, emergency thrombectomy through the femoral vein was attemped under local anesthesia. However, during the operation, inferior vena cava injury was suspected because of his abdominal pain and distension with hypotension. Laparotomy for hemostasis by intra-abdominal approach was immediately started due to progressive intra-abdominal bleeding. Massive infusion (6, 000ml) was needed to compensate 4, 500g blood loss, hence immeasurable hemodilution (Hb<2g•dl-1). Intraoperative continuous hemofiltration, substituting the infusion for the blood with a roller pump, induced a rapid recovery from hemodilution without exacerbation of the acid-base balance. We suggest that intraoperative continuous hemofiltration is highly effective for cases of severe hemodilution caused by massive bleeding and supplemental infusion.
