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Related Experiment Videos

Acute normovolemic hemodilution.

David Murray1

  • 1Department of Anesthesiology, Washington University School of Medicine, Division of Pediatric Anesthesia, Saint Louis Children's Hospital, 660 S Euclid, Box 8054, St Louis, MO 63110, USA. murrayd@notes.wustl.edu.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|June 16, 2004
PubMed
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Acute normovolemic hemodilution (ANH) is a method to reduce allogeneic blood transfusions by removing a patient's blood before surgery. The removed blood is returned later, potentially providing an acceptable red cell mass if blood loss is minimal.

Area of Science:

  • Anesthesiology
  • Transfusion Medicine
  • Surgical Patient Management

Background:

  • Reducing allogeneic blood transfusions is a priority in patient care.
  • Autologous blood is the preferred source for perioperative red cells.
  • Methods for autologous blood collection include preoperative donation, acute normovolemic hemodilution (ANH), and intraoperative cell scavenging.

Purpose of the Study:

  • To describe the principles and effectiveness of acute normovolemic hemodilution (ANH) as a method to reduce allogeneic blood use.
  • To identify key factors influencing the success of ANH in limiting perioperative transfusions.

Main Methods:

  • Acute normovolemic hemodilution (ANH) involves controlled removal of whole blood immediately before surgery.
  • Intravascular volume is maintained with non-red cell solutions during the procedure.

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  • Collected autologous blood is stored and re-infused at the end of the operation.

    • Main Results:

    • ANH results in a normal blood volume but a reduced red cell mass during surgery.
    • Successful ANH can provide an acceptable red cell mass if operative blood loss is not excessive.
    • Factors influencing ANH effectiveness include initial hematocrit, blood volume, volume of blood removed, hemodilution efficacy, and timing of re-infusion.

    Conclusions:

    • Acute normovolemic hemodilution (ANH) is a viable strategy for reducing allogeneic blood transfusions.
    • The efficacy of ANH is dependent on patient-specific factors and procedural parameters.
    • ANH offers an alternative to autologous pre-donation, with blood typically re-infused intraoperatively.