M. Oberhauser et al., ISOVOLEMIC HEMODILUTION (IHD) FOR AVOIDAN CE OF TRANSFUSION OF HOMOLOGOUS BLOOD - EFFECTIVENESS IN THE FIELD OF MAJOR GYNECOLOGICAL OPERATIONS, Infusionstherapie und Transfusionsmedizin, 23(1), 1996, pp. 15-23
Objective: The practicability and efficiency of a standardized, preope
rative isovolemic hemodilution was investigated during major gynecolog
ical operations (Wertheim's operation, etc.). Design: Prospective clin
ical trial with a historical control group. Setting: Operating room of
a gynecological university hospital. Patients and Interventions: Unde
r general anesthesia hemodilution to a hemoglobin concentration of 9 g
/dl was performed in 48 patients (mean age: 53 years). Shed blood volu
me amounted to 900 +/- 210 mi. Transfusion of autologous or homologous
blood was provided when Hb concentration decreased beyond 7 g/dl intr
aoperatively. Results: Compared to a control group of 57 patients with
out hemodilution the total number of PRBC units transfused was signifi
cantly reduced. Moreover, in 65% of all patients the transfusion of ho
mologous blood could completely be avoided perioperatively (control gr
oup: 21% of patients), Adverse effects did not occur. Conclusions: The
data reflect that acute isovolemic hemodilution before major gynecolo
gical operations represents a safe, easy to handle and effective proce
dure to avoid transfusion of homologous blood up to a total blood loss
of 1,300-1,400 ml.