[Prevention of thromboembolism by normovolemic hemodilution]

In general surgery, routine thromboprophylaxis is strongly recommended in order to reduce the risk of thrombo-embolic complications. If pre-operative hemodilution is used in order to avoid the risks of transfusions of homologous blood, dextran must be used as the diluent. Patients undergoing total hip replacement represent a very high risk group where infusion of dextran is superior to low doses of heparin, but pre-operative hemodilution using dextran is more effective than infusions of dextran. It may thus be concluded that pre-operative hemodilution with dextran would give similar improved results in general surgery. As with all thromboprophylactic agents, side-effects may occur. However, with dextran 60, anaphylactoid reactions have note been described up to the present time in patients undergoing hemodilution before operation.