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Related Experiment Videos

Perioperative hemodilution.

Uwe Kreimeier1, Konrad Messmer

  • 1kreimeier@ana.med.uni-muenchen.de

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
|August 31, 2002
PubMed
Summary

Acute normovolemic hemodilution (ANH) reduces the need for allogeneic blood transfusions in surgery. This technique is safe and effective for patients with adequate hemoglobin levels and anticipated blood loss.

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Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Transfusion Medicine
  • Surgical Hemostasis

Background:

  • Acute normovolemic hemodilution (ANH) is a blood management strategy.
  • It involves blood removal and fluid replacement before or during surgery.
  • ANH aims to minimize allogeneic blood transfusions.

Purpose of the Study:

  • To evaluate the efficacy and safety of ANH.
  • To determine the impact of ANH on homologous blood transfusion requirements.
  • To assess the feasibility of ANH in elective surgery patients.

Main Methods:

  • ANH involves simultaneous blood removal and cell-free fluid replacement.
  • Fluid replacement uses synthetic colloids like dextran or hydroxyethyl starch.
  • Patient selection criteria include initial hemoglobin > or = 12 g/dl and anticipated blood loss > or = 1500 ml.

Main Results:

  • ANH efficacy depends on initial hematocrit, target hematocrit, and transfusion triggers.
  • Target hematocrit of 20-25% (7.0-8.0 g/dl hemoglobin) is feasible and safe.
  • Lower intraoperative hemoglobin concentrations (e.g., 5.0 g/dl) have been tolerated in young patients.

Conclusions:

  • ANH is a safe and effective method for reducing homologous blood transfusions.
  • It is an integral part of blood management programs.
  • ANH can be combined with other strategies like autologous blood deposition and intraoperative blood salvage.

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