• Fortschritte der Medizin · Oct 1994

    Randomized Controlled Trial Comparative Study Clinical Trial

    [Hypervolemic hemodilution as a means of preventing homologous blood transfusion. A simple alternative to acute normovolemic hemodilution].

    • E Entholzner, L Mielke, W Plötz, A Malek, M Kling, R Burgkart, S Hargasser, and R Hipp.
    • Institut für Anasthesiologie, Klinikum rechts der Isar, Technischen Universität München.
    • Fortschr. Med. 1994 Oct 20; 112 (29): 410-4.

    ProblemAcute normovolenic hemodilution (ANH) is timeconsuming and complicated, and has only a small effect in reducing the need for homologous blood. A simpler procedure is hypervolemic hemodilution (HHD). In the present prospective, randomized study, HHD is compared with ANH for its blood-saving effect.Study DesignForty-nine patients undergoing total hip replacement were admitted. Group I (ANH): Withdrawal of 15 ml/kg bodyweight autologous blood and isovolemic replacement by hydroxyethyl starch (200/0.5). Group II (HHD): Infusion of 15 ml/kg bodyweight hydroxyethyl starch (200/0.5).ResultsNo significant differences were found between the groups in terms of Hb, hematocrit and coagulation. The blood loss (intra-operative+drainage losses) was comparable in the two groups at 1274 +/- 310 ml (HHD) and 130 +/- 335 ml (ANH). During the period under investigation, 66% of the patients in the HHD group and 57% in the ANH group required no homologous blood.ConclusionHHD is just as effective as ANH for reducing homologous blood requirements, and is much simpler to apply.

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