title: Acute normovolemic haemodilution for management of 4200 ml blood loss during radical prostatectomy.
abstract: BACKGROUND
  We refer a case report of patient with 4200 ml large blood during urological surgery, in which was used acute normovolemic haemodilution as a solely method for avoiding of allogeneic blood transfusions.
  
  
  METHODS
  A 65 years old patient was scheduled for radical prostatectomy. After starting general anaesthesia was removed 2360 g (target haematocrit 0.30 in patients with calculated total body blood volume 5460 ml) of whole blood from patient and circulation volume was replaced by 1500 ml of colloids and 2000 ml of crystalloid solution. Retransfusion was started after 1800 ml blood loss (transfusion trigger--Hct 0.20).
  
  
  RESULTS
  The total blood loss was 4200 ml during 4 hour and 40 minutes of surgery. The patient was the whole operation time haemodynamic stable, with minimal systolic blood pressure 100 mmHg and haematocrit value was 0.32 after the procedure.
  
  
  CONCLUSIONS
  To reduce the risk of anaemia and also the risk of allogeneic blood transfusion is the one of the basic part of the anaesthesia management of large urological procedures. This case demonstrated the effectiveness and safety of acute normovolemic haemodilution as a method for avoiding allogeneic blood transfusion in a patient with 77% loss of total body blood volume.
authors.affiliation: Department of Anesthesiology, University Hospital Brno, Czech Republic. rgal@iol.cz
authors.forename: R
authors.initials: R
authors.lastname: Gal
authors.forename: I
authors.initials: I
authors.lastname: Cundrle
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D001810:Blood Volume; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D008297:Male; D011468:Prostatectomy