[Perioperative anemia and erythropoiesis]

50 consecutive patients with hip arthroplasty had acute normovolaemic haemodilution and intra- and postoperative autotransfusion using Autotrans, Dideco GmbH. 18 of 50 patients received homologous blood products additionally to autotransfusion (Hb less than 8 g/dl, hemodynamic instability). There was no evidence for coagulation disorders, hypoxia or hypovolaemia during the whole investigation period (until the 10th p.o. day) though in some cases haemoglobin-levels less than 7 g% were accepted. No variations of erythropoietin levels could be observed postoperatively, suggesting that acute anaemia alone does not affect erythropoiesis. Reticulocytes, however, increased significantly from the 4th postoperative day. There was no correlation between number of reticulocytes and erythropoietin levels. Lactate levels stayed within normal range during the whole investigation period thus indicating normal microcirculation. The present data demonstrate that postoperative anaemia can be tolerated even in elder patients if intravascular volume is kept constant (normovolaemia). In accordance with recent literature the course of erythropoietin levels seemed to prove that there was no functional reduction in oxygen-availability.