Acute normovolemic haemodilution for management of blood loss during radical prostatectomy.
BACKGROUND
The reduction of the risks of anemia and allogeneic transfusion is one the basic parts of the anaesthesia management in large urological procedures. We used acute normovolemic haemodilution (ANH) as a technique of autologous blood procurement in patients scheduled for radical prostatectomy.


METHODS
15 patients undergoing radical prostatectomy were enrolled in our study. After starting general anaesthesia the left radial artery line was placed for invasive blood pressure monitoring and withdrawing blood for ANH. The restoration of circulated volume was instituted by infusion of crystalloids and colloids. Reinfusion of gained blood was started after transfusion trigger was reached (Hct 0.25).


RESULTS
The average total blood loss was in amount of 2393 +/- 238 (ml), autologous blood was infused in amount of 1919 +/- 220 (ml). The preoperative haematocrit was 41 +/- 3, after ANH 29 +/-2 and 31 +/- 3 (%) postoperatively. One unit of allogeneic blood was transfused in 2 patients only. All patients were hemodynamically stable during the entire surgery, with minimal systolic blood pressure of 100 mmHg and were extubated in the operation room with no complications.


CONCLUSIONS
This study demonstrated the effectiveness and safety of ANH as a method for avoiding the allogeneic blood transfusion in patients undergoing radical prostatectomy (Tab. 1, Ref. 10). Full Text (Free, PDF) www.bmj.sk.
Department of Anaesthesiology and Intensive Care, University Hospital Brno, Medical Faculty of Masaryk University, Brno, Czech Republic. rgal@atlas.cz
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D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D003102:Colloids; D000077324:Crystalloid Solutions; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D007552:Isotonic Solutions; D008297:Male; D010952:Plasma Substitutes; D011468:Prostatectomy
D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes