title: The effect of acute normovolemic hemodilution and acute hypervolemic hemodilution on coagulation and allogeneic transfusion.
abstract: OBJECTIVE
  In this study, acute normovolemic hemodilution (ANH) and hypervolemic hemodilution (HHD) were compared with no hemodilution with regards to the effectiveness in blood usage and coagulation parameters.
  
  
  METHODS
  The study was performed from February to August 2001 at Hacettepe University Hospital, Ankara, Turkey. Thirty patients undergoing hip arthroplasty surgery were prospectively randomized into: ANH group [autologous blood 15 mL kg(-1) was withdrawn and replaced by 6% hydroxyethylstarch (HES)] or HHD group (HES was administered without removal of any autologous blood) or the control group (no hemodilution). In all groups, blood was given when hemoglobin concentration was <9 g dl(-1).
  
  
  RESULTS
  Three groups were clinically similar regarding blood loss, mean arterial pressures and coagulation parameters. But allogeneic transfusion requirements were significantly less in hemodilution groups (20% in ANH, 40% in HHD) compared to the control group (100% of patients).
  
  
  CONCLUSIONS
  We conclude that hemodilution (both ANH and HHD) decreases the demand for homologous blood without adversely affecting hemodynamics or coagulation parameters and HHD seems to be a simple and valuable alternative to ANH in orthopedic patient undergoing hip replacement.
authors.affiliation: Department of Anesthesiology and Reanimation, Medical Faculty, Hacettepe University Sihhiye, Ankara 06100,Turkey. fatmasaricao@yahoo.com
authors.forename: Fatma
authors.initials: F
authors.lastname: Saricaoglu
authors.forename: Seda B
authors.initials: SB
authors.lastname: Akinci
authors.forename: Varol
authors.initials: V
authors.lastname: Celiker
authors.forename: Ulku
authors.initials: U
authors.lastname: Aypar
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001777:Blood Coagulation / Q000502:physiology; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D005260:Female; D006438:Hemodilution / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage; D014421:Turkey
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes