Normovolaemic haemodilution with and without autologous blood transfusion during major elective surgery: A randomized...

Transfusion of blood and blood products has become increasingly fraught with risk. The technique of preoperative haemodilution and autologous blood transfusion, which avoids the use of bank blood, is difficult to apply in peripheral hospitals where trans operative haemodilution is simpler to perform. This paper reports the results of a randomized controlled clinical trial designed to compare the efficacy of normovolaemic haemodilution with and without autologous blood transfusion in the saving of bank blood during major elective surgery.

Forty-eight patients were allocated to one of three groups-a control group in whom bank blood was used, a preoperative haemodilution group in whom autologous blood was withdrawn before operation, and a transoperative haemodilution group in whom 3.5% polygeline replaced blood loss during operation.

The analysis shows that in 36 patients who lost 1 to 2 L of blood there was a highlysignificant difference between the control and the haemodilution groups in the amount of bank blood transfused. More than 500 ml of bank blood per person was saved in the two haemodilution groups. The difference in the saving of bank blood between the preoperative dilution group and the trans operative dilution group was not statistically significant.

Transoperative haemodilution using polygeline can achieve considerable saving in the use of bank blood during elective surgery when the blood loss is less than 2L. The technique issuitable for use in peripheral hospitals.