title: [How should we perform acute normovolemic hemodilution during radical prostatectomy? Comparison with a mathematical model].
abstract: BACKGROUND
  Although allogenic blood transfusion has become safer than ever, there still exist some risks such as infection and immunomodulation. The importance of autologous blood transfusion is emphasized.
  
  
  METHODS
  Fourteen cases of radical prostatectomy performed with the use of acute normovolemic hemodilution (ANH) were examined retrospectively. The efficacy of ANH was evaluated in comparison with a mathematical model.
  
  
  RESULTS
  The average blood loss was 1321 ml and the average blood volume collected during ANH was 637 ml. In no cases, allogenic blood transfusion was necessary. According to a mathematical model, however, the actual blood loss was smaller than the calculated allowable blood loss in all the cases, which implied allogenic blood transfusion would have been avoidable even without ANH. It was also suggested that only a limited efficacy was obtained due to a relatively small blood volume collected during ANH.
  
  
  CONCLUSIONS
  Our way of performing ANH was considered suboptimal in that no efficacy was found as to avoidance of allogenic blood transfusion and the extent of ANH was not sufficient to prepare for unexpected massive blood loss. It seemed necessary to reconsider the indications for ANH to increase the efficacy. The importance of the informed consent was also recognized.
authors.affiliation: Department of Anesthesiology, Showa General Hospital, Kodaira 187 8510.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Bougaki
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sawamura
authors.forename: Kanako
authors.initials: K
authors.lastname: Sato
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogawa
authors.forename: Fusako
authors.initials: F
authors.lastname: Matsushita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hanaoka
mesh_terms: D001804:Blood Transfusion, Autologous / Q000379:methods*; D006438:Hemodilution; D006801:Humans; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D008962:Models, Theoretical; D011468:Prostatectomy; D012189:Retrospective Studies