Changes in Perioperative Blood Volume and Fluid Distribution in Patients Undergoing Primary Total Hip Replacement.

Perioperative Change in Blood Volume and Fluid Distribution in Total Hip Arthroplasty

Clinical assessment of bleeding and calculation of perioperative blood loss do not provide an accurate estimate of blood volume. This makes rational fluid management difficult, which is of high importance for patient-related outcomes. The availability of carbon monoxide(CO)-rebreathing allows for simple, non-invasive and precise measurement of changes in blood volume.

The purpose of the study is to investigate and describe changes in blood volume and fluid distribution perioperative in patients undergoing total hip arthroplasty. Furthermore, to investigate the association between changes in blood volume and incidence of orthostatic insufficiency.

Inclusion Criteria:

• Patients scheduled for an elective total hip arthoplasty (THA) in a standardized fast track setting.
• Capable of participating in CO-rebreathing measurement
• Age ≥ 18 years
• Able to speak and understand Danish
• Has provided written informed consent.

Exclusion Criteria:

• Intraoperative blood loss exceeding 750 mL.
• Perioperative need for a blood transfusion.
• Confirmed or suspected coagulopathies.
• Factors that make CO-rebreathing measurement impossible.
• Known orthostatic intolerance.
• American Society of Anesthesiologists physical status (ASA) classification ≥ 4.