[The present possibilities for routine use of blood-saving measures from the anesthesiologic point of view--theoretical basis and clinical practice. I. Potential risks of homologous transfusion; normovolemic hemodilution].
This paper, which is the first part of four, deals with the potential risks of homologous blood transfusion as well as with normovolemic hemodilution, an autologous transfusion method, which is easily to be applied and not expensive. Although the various methods of autologous transfusion are well known for many years the public discussion on the "AIDS-topic" has led to a growing interest in blood-saving measures. However, in contrast to the so-called "AIDS-topic" the potential risks of a transfusion-transmitted hepatitis as well as the immunologic effects of homologous blood are of much greater importance. Moreover, high-court-sentences give the legal background for intensifying autologous transfusion and to offer it to the patients. So far there are four autologous transfusion methods to be applied routinely: 1. normovolemic hemodilution (NHD); 2. intra- and/or postoperative blood salvage (I/PBS) with or without autologous direct-retransfusion (ADR); 3. preoperative autologous plasmapheresis (PPH); 4. preoperative autologous blood donation (ABD). Moreover, drug-induced stimulation of the erythropoiesis by means of erythropoietin and the additional (intravenous) administration of iron may become a further component among autologous transfusion methods. Normovolemic hemodilution means exchange of autologous blood versus an artificial colloid. To make sure for normovolemia is to be considered a "conditio sine qua non" for "functioning" of normovolemic hemodilution.(ABSTRACT TRUNCATED AT 250 WORDS)
Singbartl
G
G
Abteilung Anästhesiologie, Intensiv- und Transfusionsmedizin, ENDO-KLINIK, Hamburg.
Schleinzer
W
W
D000075202:Contraindications; D006438:Hemodilution / Q000009:adverse effects*; D006801:Humans; D012306:Risk; D065227:Transfusion Reaction
Potentielle Risiken der homologen Transfusion; normovolmische Hämodilution.