[Hypervolemic hemodilution as a means of preventing homologous blood transfusion. A simple alternative to acute normovolemic hemodilution].
OBJECTIVE
Acute normovolenic hemodilution (ANH) is timeconsuming and complicated, and has only a small effect in reducing the need for homologous blood. A simpler procedure is hypervolemic hemodilution (HHD). In the present prospective, randomized study, HHD is compared with ANH for its blood-saving effect.


METHODS
Forty-nine patients undergoing total hip replacement were admitted. Group I (ANH): Withdrawal of 15 ml/kg bodyweight autologous blood and isovolemic replacement by hydroxyethyl starch (200/0.5). Group II (HHD): Infusion of 15 ml/kg bodyweight hydroxyethyl starch (200/0.5).


RESULTS
No significant differences were found between the groups in terms of Hb, hematocrit and coagulation. The blood loss (intra-operative+drainage losses) was comparable in the two groups at 1274 +/- 310 ml (HHD) and 130 +/- 335 ml (ANH). During the period under investigation, 66% of the patients in the HHD group and 57% in the ANH group required no homologous blood.


CONCLUSIONS
HHD is just as effective as ANH for reducing homologous blood requirements, and is much simpler to apply.
Entholzner
E
E
Institut für Anasthesiologie, Klinikum rechts der Isar, Technischen Universität München.
Mielke
L
L
Plötz
W
W
Malek
A
A
Kling
M
M
Burgkart
R
R
Hargasser
S
S
Hipp
R
R
D016063:Blood Loss, Surgical / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006438:Hemodilution / Q000379:methods*; D006622:Hip Prosthesis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D011446:Prospective Studies
D006895:Hydroxyethyl Starch Derivatives