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[Isovolemic hemodilution for avoiding homologous blood transfusions: effectiveness in large gynecologic
M Oberhauser1, H J Bardenheuer, H Bernasconi
1Institut für Anaesthesiologie, Ludwig-Maximilians-Universität München, Deutschland.
Objective:
The practicability and efficiency of a standardized, preoperative isovolemic hemodilution was investigated during major gynecological operations (Wertheim's operation, etc.).
Design:
Prospective clinical trial with a historical control group.
Setting:
Operating room of a gynecological university hospital.
Patients And Interventions:
Under general anesthesia hemodilution to a hemoglobin concentration of 9 g/dl was performed in 48 patients (mean age: 53 years). Shed blood volume amounted to 900 +/- 210 ml. Transfusion of autologous or homologous blood was provided when Hb concentration decreased beyond 7 g/dl intraoperatively.
Results:
Compared to a control group of 57 patients without hemodilution the total number of PRBC units transfused was significantly reduced. Moreover, in 65% of all patients the transfusion of homologous blood could completely be avoided perioperatively (control group: 21% of patients). Adverse effects did not occur.
Conclusions:
The data reflect that acute isovolemic hemodilution before major gynecological operations represents a safe, easy to handle and effective procedure to avoid transfusion of homologous blood up to a total blood loss of 1,300-1,400 ml.