Acute normovolemic hemodilution has been reported to result in blood savings varying from 18% to 90%. Very few of these are randomized prospective studies. This study attempts to determine the blood transfusion savings if acute normovolemic hemodilution is used in combination with autologous predonated blood and cell saver. Thirty-three patients undergoing total hip arthroplasty were assigned randomly to one of two groups (control, n = 16; hemodilution, n = 17). Patients in both groups entered an autologous predonation program if cleared medically and were placed on Cell Saver intraoperatively and in the postanesthesia care unit. In addition, the hemodilution group underwent acute normovolemic hemodilution preoperatively. Only 41% of the patients in the hemodilution group required any autologous blood transfusion as compared with 75% of the control group. In addition, the hemodilution group required a mean lower quantity of autologous blood transfusion (41% of the estimated blood loss) as compared with the control group (71%). The net anesthesia time increased by an average of 11.4 minutes in the hemodilution group. Acute normovolemic hemodilution is a safe procedure even in an older patient population. Hemodilution resulted in fewer patients needing autologous predonated blood transfusions. The major benefit of hemodilution was seen when predonation was not possible.

译文

据报道,急性降血常规血液稀释可节省18%至90%的血液。这些很少是随机的前瞻性研究。这项研究试图确定如果将急性等渗血液稀释与自体预先捐献的血液和细胞保护剂结合使用可节省的输血量。将接受全髋关节置换术的33例患者随机分为两组(对照组,n = 16;血液稀释,n = 17)。两组患者均在接受医学检查后进入了自体捐赠程序,并在术中和麻醉后监护病房接受了Cell Saver治疗。另外,血液稀释组术前进行了急性等渗血液稀释。血液稀释组中只有41%的患者需要自体输血,而对照组为75%。此外,血液稀释组与对照组(71%)相比平均需要较少量的自体输血(估计失血量的41%)。血液稀释组的净麻醉时间平均增加了11.4分钟。即使在年龄较大的患者中,急性降血常规血液稀释也是一种安全的方法。血液稀释导致更少的患者需要自体先验的输血。当无法进行预先捐赠时,可以看到血液稀释的主要好处。

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