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Acute normovolemic hemodilution in moderate blood loss surgery: a randomized controlled trial
Author(s) -
Bennett Joanne,
Haynes Sarah,
Torella Francesco,
Grainger Hannah,
McCollum Charles
Publication year - 2006
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2006.00857.x
Subject(s) - medicine , blood transfusion , anesthesia , surgery , randomized controlled trial , odds ratio
BACKGROUND: The risks associated with allogeneic blood transfusion are increasingly recognized. More blood is cross‐matched for moderate blood loss surgery than any other indication. The role of acute normovolemic hemodilution (ANH) as a blood transfusion strategy was evaluated in a prospective randomized controlled trial. STUDY DESIGN AND METHODS: A total of 155 patients undergoing elective hip surgery were randomly assigned to either “ANH” (n = 78) or “standard transfusion” (n = 77). ANH on induction of anesthesia was to a target hemoglobin (Hb) level of 110 g per L with return of autologous blood on wound closure. Allogeneic blood was prescribed by an objective transfusion trigger based on an Hb level of less than 80 g per L. Transfusion requirements and postoperative complications were recorded. RESULTS: Allogeneic transfusion was necessary in 22 (29%) standard transfusion patients and 15 (19%) ANH (odds ratio [OR], 0.6; 95% CI, 0.28‐1.3; p = 0.23) with 63 and 33 units transfused, respectively (p = 0.1). Significant postoperative complications occurred in 30 (38%) standard transfusion patients compared with 14 (18%) of those randomly assigned to ANH (OR, 0.3; 95% CI, 0.14‐0.65; p = 0.009). The major difference between the groups was the frequency of infective complications. CONCLUSION: Despite modest allogeneic transfusion requirements in hip surgery, ANH reduced postoperative complications.