• M Rehm, V H Orth, E Weninger, M Jacob, S Mayer, H Brechtelsbauer, and U Finsterer.
• Klinik für Anästhesiologie, Ludwig-Maximilians-Universität, Klinikum Grosshadern, München. jfreeden@ana.med.uni-muenchen.de
• Anaesthesist. 2001 Aug 1; 50 (8): 580-4.

QuestionIs polygeline (Haemaccel) a suitable colloid to perform preoperative acute normovolemic hemodilution (ANH) and to replace a large intraoperative blood loss?MethodsIn a sixty-eight-year-old patient undergoing radical hysterectomy preoperative ANH was performed to a hematocrit of 23% using 3.5% polygeline (Haemaccel). Intraoperative retransfusion of ANH blood was started at a hematocrit of 13%. Plasma volume (indocyanine green-dilution technique) and hematocrit were measured before and after ANH, 3 times intraoperatively (once before retransfusion) and postoperatively. Red cell volume (by labelling erythrocytes with fluorescein) was determined before and after ANH, before retransfusion, and postoperatively.ResultsAfter removal of 1,940 ml of blood and replacement with 15% more of colloid, blood volume decreased by 760 ml. After a mean blood loss of 4,600 ml, 290 ml and 260 ml of red cells were saved due to ANH and use of a cell saver, respectively.ConclusionsThe exact double label measurements of blood volume demonstrated that polygeline, which has a volume effect of only 50%, cannot be considered to be a suitable colloidal substitute during ANH.

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