ISOVOLEMIC HEMODILUTION (IHD) FOR AVOIDAN CE OF TRANSFUSION OF HOMOLOGOUS BLOOD - EFFECTIVENESS IN THE FIELD OF MAJOR GYNECOLOGICAL OPERATIONS

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.