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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
Unlabelled:
OPTIMIZED HEMODILUTION: To avoid blood transfusions, the method of optimized hemodilution (OHD) was developed. OHD consists of preoperative hypervolemic hemodilution with 500 ml hydroxyethyl starch (HES) and consecutive volume replacement with HES in the case of intraoperative intravasal fluid loss. This study verifies the efficacy of OHD.
Results:
Mono- and bimaxillary operations (n = 213) performed between January 1995 and May 1999 were evaluated retrospectively with respect to reduction of blood transfusions due to application of OHD. The average blood loss in the OHD group (n = 127) was 593 ml, and no blood transfusion was required. In contrast, the control group (n = 86) showed an average blood loss of 738 ml, and 15% of these patients (n = 13) required transfusion of a total of 18 blood units. Based on our results, provision of autologous blood is only necessary for patients who do not receive OHD. The costs of fluid replacement and transfusion are increased by a factor of 5.7 when OHD is not used.
Discussion:
OHD should be preferably used in cases of elective surgery on patients with good cardiopulmonary health. It is an easy to handle infusion regimen, which does not require additional monitoring, has no risk of infection, and results in a significant cost reduction.