ACUTE NORMOVOLEMIC HEMODILUTION AND IDIOPATHIC SCOLIOSIS SURGERY - EFFECTS ON HOMOLOGOUS BLOOD REQUIREMENTS

After the introduction of acute normovolaemic haemodilution (NVHD) in our hospital, we prospectively studied 19 patients managed with modera te NVHD (mean haematocrit 0.28, SD 0.02) during idiopathic scoliosis s urgery (mean angle 53.2, SD 16.7 degrees) with the Cotrel-Dubousset in strumentation (CDI). Our standard scoliosis anaesthetic technique was used. Intraoperatively, one patient received one unit of homologous bl ood. Postoperatively, seven patients received ten units of homologous blood. Homologous blood used was reduced by about 83% for this procedu re in our institution. In the assessment of fluid and blood requiremen ts we found physical signs reflecting tissue perfusion and oxygen supp ly more reliable than the estimated blood loss using the suction bottl e and swabs. The similar postoperative complications (nine fever, five atelectasis/pneumonia, one urinary infection, one phlebitis), anaesth etic duration (mean 5.21, SD 1.13) hours, hospitalisation (mean 6.67, SD 1.19) days and return to normal activity (mean 8, SD 7.68) weeks in dicate that the NVHD patients did just as well as with our previous re gimen when only homologous blood was used.