title: Giving both enoxaparin and dextran increases the need for transfusion in revision hip arthroplasty.
abstract: OBJECTIVE
  To find out if the need for transfusion was increased by volume substitution with dextran 70 in patients receiving prophylaxis against thrombosis with low molecular weight heparin.
  
  
  METHODS
  Open randomised controlled trial.
  
  
  METHODS
  University hospital, Sweden.
  
  
  METHODS
  40 patients undergoing revision hip arthroplasty.
  
  
  METHODS
  Enoxaparin 40 mg was given daily. Intraoperative normovolaemia was maintained with albumin (n = 20) or dextran 70 (n = 20). Intraoperative autotransfusion was used. Packed cell volume was kept above 0.29, if necessary with homologous blood.
  
  
  METHODS
  External blood loss, red cell balance.
  
  
  RESULTS
  Dextran patients received 0.64 (0.2) g/kg of dextran (mean (SD)) and required more (p < 0.05) homologous blood (3.8 (2.4) units) than those receiving albumin (2.3 (1.6) units). The initial and final packed cell volumes were similar (0.40 and 0.32 compared with 0.41 and 0.32, respectively). The calculated loss of red cells was larger in the dextran group (1401 (511) compared with 1077 (374); p < 0.05).
  
  
  CONCLUSIONS
  The combination of enoxaparin and dextran appreciably increased the need for transfusion compared with enoxaparin alone.
authors.affiliation: Department of Anaesthesiology and Intensive Care, University Hospital, Linköping, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Lisander
authors.forename: S A
authors.initials: SA
authors.lastname: Jacobsson
authors.forename: I
authors.initials: I
authors.lastname: Ivarsson
authors.forename: M
authors.initials: M
authors.lastname: Vegfors
authors.forename: O
authors.initials: O
authors.lastname: Engdahl
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001804:Blood Transfusion, Autologous; D003911:Dextrans / Q000627:therapeutic use*; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use*; D012086:Reoperation
chemical_list: D000925:Anticoagulants; D003911:Dextrans; D017984:Enoxaparin; D010952:Plasma Substitutes