Combination of blood-saving methods decreases homologous blood requirements in scoliosis surgery.
A study was conducted in patients undergoing surgery for idiopathic scoliosis, to determine whether combining blood-saving methods would decrease the need for homologous blood. Five groups were compared in a prospective, randomized fashion. In control patients (n = 13), blood loss was replaced by colloids. Preoperative haemodilution (PHD group) was used in ten patients. In the intraoperative autotransfusion (IAT) group (n = 11), washed red cells were returned to the patient. In the PHD+IAT group, both methods were combined (n = 13). In the fifth group, in addition, arterial hypotension was maintained with sodium nitroprusside (the PHD+IAT+HA group, n = 10). The haemoglobin value was kept above 79 g/l. Total blood loss did not differ between groups. The use of homologous blood in the PHD+IAT and PHD+IAT+HA groups was significantly less than in controls. It is concluded that blood-saving measures can be combined with an augmentative effect.
Department of Anaesthesia, University Hospital, Linköping, Sweden.
B
B
Lisander
R
R
Jonsson
A
A
Nordwall
D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001802:Blood Substitutes / Q000627:therapeutic use; D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D003102:Colloids / Q000627:therapeutic use; D017707:Erythrocyte Transfusion; D005260:Female; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007023:Hypotension, Controlled; D007430:Intraoperative Care; D008297:Male; D009599:Nitroprusside / Q000627:therapeutic use; D011300:Preoperative Care; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*
D000959:Antihypertensive Agents; D001802:Blood Substitutes; D003102:Colloids; D006454:Hemoglobins; D009599:Nitroprusside