[Isovolemic hemodilution for avoiding homologous blood transfusions: effectiveness in large gynecologic interventions].
OBJECTIVE
The practicability and efficiency of a standardized, preoperative isovolemic hemodilution was investigated during major gynecological operations (Wertheim's operation, etc.).


METHODS
Prospective clinical trial with a historical control group.


METHODS
Operating room of a gynecological university hospital.


METHODS
Under general anesthesia hemodilution to a hemoglobin concentration of 9 g/dl was performed in 48 patients (mean age: 53 years). Shed blood volume amounted to 900 +/- 210 ml. Transfusion of autologous or homologous blood was provided when Hb concentration decreased beyond 7 g/dl intraoperatively.


RESULTS
Compared to a control group of 57 patients without hemodilution the total number of PRBC units transfused was significantly reduced. Moreover, in 65% of all patients the transfusion of homologous blood could completely be avoided perioperatively (control group: 21% of patients). Adverse effects did not occur.


CONCLUSIONS
The data reflect that acute isovolemic hemodilution before major gynecological operations represents a safe, easy to handle and effective procedure to avoid transfusion of homologous blood up to a total blood loss of 1,300-1,400 ml.
Oberhauser
M
M
Institut für Anaesthesiologie, Ludwig-Maximilians-Universität München, Deutschland.
Bardenheuer
H J
HJ
Bernasconi
H
H
Genz
T
T
Kreimeier
U
U
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D005260:Female; D006438:Hemodilution / Q000379:methods*; D006452:Hemoglobinometry; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D007044:Hysterectomy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000601:surgery*; D010052:Ovariectomy; D010952:Plasma Substitutes / Q000008:administration & dosage; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000601:surgery*
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes
Isovolämische Hämodilution (IHD) zur Einsparung von Fremdbluttransfusionen: Effektivität bei grossen gynäkologischen Eingriffen.