Korean J Anesthesiol.  2003 Jul;45(1):87-91. 10.4097/kjae.2003.45.1.87.

Effect of Acute Normovolemic Hemodilution on Postoperative Allogenic Blood Requirement after Total Knee Arthroplasty

• Kim DY
• Choi SR
• Chung CJ
• Chin YJ

• KMID: 2236744
• DOI: http://doi.org/10.4097/kjae.2003.45.1.87

Abstract

BACKGROUND: Acute normovolemic hemodilution (ANH) is recognized as the easiest, the most economical and valuable autologous blood saved method among the types of autotransfusion. We studied whether this method could reduce the transfusion requirement of allogenic blood in total knee arthroplasty to investigate the efficacy of ANH.
METHODS
The thirty patients were randomized and divided into two groups. In the ANH group (n = 15), 2 units of autologous blood were procured from a CVP catheter immediately before or after anesthetic induction, while Ringer's lactate and colloid solution were infused to maintain normovolemia via a different venous catheter. Perioperative changes of hemoglobin, hematocrit, platelets, prothrombin time (PT), transfusion requirements and the amount of postoperative drainage were compared.
RESULTS
There were no significant difference between the two groups in terms of perioperative changes of hemoglobin, hematocrit or platelets. And, there was significantly reduced demand for packed RBC transfusion in the ANH group (362.7+/-236.4 ml) compared with the control group (668.0+/-259.3 ml) (P <0.05). However, no significant difference was observed between the two groups in terms of postoperative drainage amount.
CONCLUSIONS
ANH can reduce transfusion requirements in total knee arthroplasty surgery if this is accompanied by appropriate patient selection and monitoring.

Keyword

acute normovolemic hemodilution; allogenic blood; autologous transfusion; total knee arthroplasty

MeSH Terms

Arthroplasty*
Blood Transfusion, Autologous
Catheters
Colloids
Drainage
Hematocrit
Hemodilution*
Humans
Knee*
Lactic Acid
Patient Selection
Prothrombin Time
Colloids
Lactic Acid