THE EFFECT OF ACUTE NORMOVOLEMIC HEMODILUTION ON HOMOLOGOUS BLOOD REQUIREMENTS AND TOTAL ESTIMATED RED-BLOOD-CELL VOLUME LOST

Background: Acute normovolemic hemodilution combined with retransfusio n is one of the various techniques proposed to avoid homologous blood transfusion in cardiac surgery. The purpose of the present paper is to study the effect of the volume of autologous blood collected pre-card iopulmonary bypass (CPB) on homologous blood requirements and total es timated red blood cell (RBC) volume lost in coronary artery bypass gra fting (CABG) surgery. Methods: Following induction of anesthesia, sequ estration of one (5-8 ml/kg; Group I, n=14) or two units (12-15 ml/kg; Group II, n=14) of fresh autologous blood was performed under electro cardiographic and hemodynamic control. Group III (n=14) was designated as the control group. Autologous blood was reinfused at the conclusio n of CPB. Results: The use of homologous blood in the study groups was significantly less than in the control group. High-volume phlebotomy did not make a significant difference in the requirement of the homolo gous blood, while causing a mild increase in the total estimated RBC v olume lost. No significant differences could be demonstrated in preope rative, post-CPB and discharge hematocrit levels and postoperative blo od drainage between the groups. Conclusion: Acute intraoperative hemod ilution with high- and low-volume phlebotomy reduced the homologous bl ood requirements similarly regardless of the amount of phlebotomy. (C) Acta Anaesthesiologica Scandinavica 41 (1997).