[How should we perform acute normovolemic hemodilution during radical prostatectomy? Comparison with a mathematical model].
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.
Bougaki
Masahiko
M
Department of Anesthesiology, Showa General Hospital, Kodaira 187 8510.
Sawamura
Shigehito
S
Sato
Kanako
K
Ogawa
Makoto
M
Matsushita
Fusako
F
Hanaoka
Kazuo
K
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