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[Optimized hemodilution with hydroxyethyl starch. A blood saving method in malocclusion operations].
C Galli1, I F Brandes, J E Otten
1Anästhesiologische Universitätsklinik, Albert-Ludwigs-Universität Freiburg, Hugstetter Strasse 55, 79106 Freiburg. ibrandes@uni-freiburg.de
Mund-, Kiefer- Und Gesichtschirurgie : MKG
|February 13, 2002
Summary
Optimized hemodilution (OHD) effectively reduces blood loss and eliminates the need for transfusions in elective surgeries. This method offers significant cost savings and is recommended for healthy patients undergoing surgery.
Area of Science:
- Anesthesiology
- Surgical Innovation
- Transfusion Medicine
Context:
- Blood transfusions are a common concern in surgical procedures, carrying risks and increasing costs.
- Optimized hemodilution (OHD) was developed as a strategy to minimize or eliminate the need for allogeneic blood transfusions.
- This study retrospectively evaluated the efficacy of OHD in reducing blood transfusions during mono- and bimaxillary operations.
Purpose:
- To verify the efficacy of optimized hemodilution (OHD) in reducing intraoperative blood loss and the requirement for blood transfusions.
- To compare the outcomes of patients undergoing OHD with a control group that did not receive this intervention.
- To assess the cost-effectiveness of OHD compared to conventional management.
Summary:
- A retrospective analysis of 213 mono- and bimaxillary operations showed that OHD significantly reduced average blood loss (593 ml) compared to the control group (738 ml).
- No blood transfusions were required in the OHD group (n=127), whereas 15% of the control group (n=86) needed transfusions.
- OHD involves preoperative hypervolemic hemodilution with hydroxyethyl starch (HES) and intraoperative volume replacement with HES, proving effective in preventing transfusion needs.
Impact:
- OHD is a safe, easy-to-handle infusion regimen suitable for elective surgeries in patients with good cardiopulmonary health.
- The implementation of OHD leads to a significant reduction in blood transfusions and associated costs, increasing them by a factor of 5.7 when not used.
- Autologous blood provision is deemed necessary only for patients not undergoing OHD, highlighting its role in optimizing surgical resource allocation.