HEMODILUTION WITH OTHER BLOOD REINFUSION TECHNIQUES IN TOTAL HIP-ARTHROPLASTY

Acute normovolemic hemodilution has been reported to result in blood s avings varying from 18% to 90%. Very few of these are randomized prosp ective studies, This study attempts to determine the blood transfusion savings if acute normovolemic hemodilution is used in combination wit h autologous predonated blood and cell saver. Thirty-three patients un dergoing total hip arthroplasty were assigned randomly to one of two g roups (control, n = 16: hemodilution, n = 17), Patients in both groups entered an autologous predonation program if cleared medically and we re placed on Cell Saver intraoperatively and in the postanesthesia car e unit, In addition, the hemodilution group underwent acute normovolem ic hemodilution preoperatively. Only 41% of the patients in the hemodi lution group required any autologous blood transfusion as compared wit h 75% of the control group, In addition, the hemodilution group requir ed a mean lower quantity of autologous blood transfusion (41% Of the e stimated blood loss) as compared with the control group (71%). The net anesthesia time increased by an average of 11.4 minutes in the hemodi lution group. Acute normovolemic hemodilution is a safe procedure even in an older patient population, Hemodilution resulted in fewer patien ts needing autologous predonated blood transfusions, The major benefit of hemodilution was seen when predonation was not possible.