[Blood saving--what do we use instead? Fluid substitution during surgery of abdominal aortic aneurysm]

The use of blood components in major surgery has been reduced significantly. Full agreement exists that patients should be held normovolemic. However, the selection of blood substitutes is controversial. In the present study we analysed infusion and transfusion policy in seven major Norwegian hospitals during and following aortic surgery. The number of patients who underwent surgery for abdominal aortic aneurysm increased significantly from 1983 to 1988. The proportion of emergency operations remained unaltered. We found a significant reduction in the use of blood components. The amount of clear solutions remained unchanged. Two hospitals had chosen polygeline as the main blood substitute, six hospitals preferred dextran 70 as a combined volume substitute and prophylaxis against thrombosis. Two hospitals used albumin 4% as recommended by the blood banks, and four used autotransfusion. Both mortality and morbidity decreased during the five-year period.