Phlebotomy of 500 or 750 milliliters of whole blood followed by isovolemic hemodilution or autologous transfusion yields similar hemodynamic, hematologic, and biochemical effects

Abstract

The purpose of this study was to evaluate the effects of phlebotomy of 500 or 750 ml of whole blood followed by isovolemic hemodilution or autologous transfusion on hemodynamic, hematologic, and biochemical parameters in healthy subjects. Four groups of normovolemic male subjects (n = 6 or 7 per group), aged 18 to 41 years, participated in this 10-day study at Upjohn Research Clinics, Kalamazoo, Mich. On day 1 two groups had phlebotomy of 500 ml; of these, one group underwent immediate postphlebotomy autologous transfusion (group 1) and the other underwent immediate postphlebotomy isovolemic hemodilution and then autologous transfusion on day 3 (group 2). Two other groups had 750 ml phlebotomy, also on day 1; of these, one group underwent immediate postphlebotomy autologous transfusion (group 3) and one underwent immediate postphlebotomy isovolemic hemodilution followed by autologous transfusion on day 3 (group 4). Noninvasive measurement of vital signs, blood pressure, and cardiac function; oximetry; and select hematologic and biochemical parameters were made. On day 1 in groups 2 and 4 transient reductions in hematocrit, hemoglobin, red blood cell count, fibrinogen, and albumin were seen concurrent with prolongation of coagulation studies. Erythropoietin was increased severalfold on day 3 (groups 2 and 4, p < 0.001). The physiologic response to phlebotomy of 500 or 750 ml was similar and was well tolerated in normal subjects.