Red Blood Cell Saving with Acute Preoperative Hemodilution

概要

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Although acute preoperative hemodilution (APH) has been used to minimize allogenic blood transfusions, the effectiveness of APH in saving red blood cell (RBC) volume has not been clarified. Therefore, we have studied the efficacy of APH in patients who received radical prostatectomy. We retrospectively compared the transfusion volume and hematocrit (Hct) in both consecutive patients who underwent APH (APH group, n=31) and those who had no APH (non-APH group, n=22). There was no significant difference between the APH group and non-APH group in the bleedout volume during surgery, 2830±1996ml vs 3181±1339ml, respectively. The intraoperative Hct in the APH group was significantly lower than in the non-APH group (27.6±2.1% vs 32.1±2.9%, p<0.0001). The RBC bleedout loss (779±532ml) during surgery in the APH group was significantly lower than in the non-APH group (1022±449ml, p<0.05). If APH had not been performed, intraoperative Hct would have been 31.2±2.2%, which is the same value as in the non-APH group. The expected RBC bleedout loss in the APH group would have been 876±585ml, therefore the net saved volume of RBC during surgery in the APH group was 97±77ml. These results demonstrate that APH could save intraoperative RBC volume loss and that APH was also a useful technique reducing allogenic blood transfusion.
北里大学の論文
1996-08-31