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Abstract: PO1106

Acute Hemoglobin Level Drop Based on Body Volume Gained

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Pham, Phuong-Chi T., UCLA Medical Center Olive View, Sylmar, California, United States
  • Pham, Phuong-Thu T., UCLA Medical Center Olive View, Sylmar, California, United States
Background

Hemoglobin (Hb) changes with blood transfusions have been widely studied, but to our knowledge, Hb drop associated with volume gained have not been studied. High fluid volume infusion in critically ill patients always result in Hb drop, but the acceptable extent of Hb drop is generally a clinical guess. We herein started a pilot study to assess Hb changes based on daily volume gained among anuric hemodialysis patients.

Methods

Chronic anuric hemodialysis (HD) patients without active bleed admitted to our institution for reasons other than dialysis were included. Strict input/output measurements and Hb levels peri-HD were obtained. Post-HD levels were measured at least 12h post treatment to allow for equilibrated fluid comparmentalization. Changes in Hb per L of body volume gained were calculated.

Results

10 consecutive HD individuals were included. Average age 60.7+7.2 years, 6 males, 4 females, estimated fat free mass (FFM) 49.3+5 Kg, pre-HD Hb 9.74+1.28, post-HD Hb 9.36+1.28 g/dL, positive fluid balance per patient 1182+775 mL. Average Hb drop was -0.19+0.58 g/dL per L of fluid gained, or 0.004+0.12 g/dL/L of fluid gained/Kg of FFM.

Conclusion

Hemoglobin drop with large fluid infusion may be studied in the anuric HD population. Our pilot study indicates thus far that Hb drop may be ~0.2 g/dL/L on average or a maximum of ~0.8 g/dL per liter of positive fluid balance. Additional data are being collected. Our study may help clinicians gauge for possible blood loss during large fluid infusion required for hemodynamically unstable patients.