Homeostatic Blood States Theory

Book excerpt: Intravenous fluid and blood component resuscitation is an integral part of modern medicine practice in a variety of medical fields. However, these therapies are usually led by rigid and very approximate guidelines. The purpose of creating the Homeostatic blood states theory was to develop more accurate guidelines. On the basis of the new theory the following results have been reached: 1. The physiological-mathematical model explaining blood volume homeostasis has been created; 2. Nomograms for infusion therapy measures, blood loss evaluation and calculating red blood cell transfusion amount were proposed; 3. Nomograms were built on the background of interfering relationship of blood hematocrit and hemoglobin concentration; 4. New guidelines for infusion therapy, blood loss evaluation and calculating transfusion amount for proper hematocrit increase were proposed; 5. New method for early verification of occult bleeding has been suggested. Three major homeostatic blood states were described: (1) target state, (2) state of maximal isoosmotic plasma dilution and (3) dehydration. Target states maintain optimal red cell mass and blood volume correlation. Other two maintain critical plasma hydration origin deviations from target state. Three new nomograms enable planning and evaluation of infusion therapy and red cell mass transfusion, quantitate evaluation of blood loss and early detection of occult bleeding based on the dynamics of blood hematocrit and hemoglobin concentration.