B. Lisander et al., GIVING BOTH ENOXAPARIN AND DEXTRAN INCREASES THE NEED FOR TRANSFUSIONIN REVISION HIP-ARTHROPLASTY, The European journal of surgery, 162(11), 1996, pp. 861-866
Objective: To find out if the need for transfusion was increased by vo
lume substitution with dextran 70 in patients receiving prophylaxis ag
ainst thrombosis with low molecular weight heparin. Design: Open rando
mised controlled trial. Setting: University hospital, Sweden. Subjects
: 40 patients undergoing revision hip arthroplasty. Interventions: Eno
xaparin 40 mg was given daily. Intraoperative normovolaemia was mainta
ined with albumin (n = 20) or dextran 70 (n = 20). Intraoperative auto
transfusion was used. Packed cell volume was kept above 0.29, if neces
sary with homologous blood. Main outcome measures: External blood loss
, red cell balance. Results: Dextran patients received 0.64 (0.2) g/kg
of dextran (mean (SD)) and required more (p < 0.05) homologous blood
(3.8 (2.4) units) than those receiving albumin (2.3 (1.6) units). The
initial and final packed cell volumes were similar (0.40 and 0.32 comp
ared with 0.41 and 0.32, respectively). The calculated loss of red cel
ls was larger in the dextran group (1401 (511) compared with 1077 (374
); p < 0.05). Conclusion: The combination of enoxaparin and dextran ap
preciably increased the need for transfusion compared with enoxaparin
alone.