Replacement of operative blood loss of more than 1 liter with Hartmann's solution.

A hundred patients each lost over 1,000 ml of blood while undergoing surgery and received two to three times that volume of Hartmann's solution. Postoperative mortality and morbidity were not affected by the lack of blood in the replacement regimen. Age group and physical condition of these patients were representative of the hospital population, and patients over 60 years old in American Society of Anesthesiologists (ASA) risk classifications 3 and 4 were included. Eighty-six percent of the group lost from 1 to 1.5 liters of blood; only 14% lost a larger amount. Serum electrolyte levels were unaffected. Hematocrit readings and total protein concentrations decreased but remained within physiologic limits. No unexpected complications were encountered in the postoperative period, and hospitalization was not prolonged. Only four patients required subsequent transfusions postoperatively.