[Clinical observation of acute hypervolemic hemodilution in scoliosis surgery on children].
OBJECTIVE
To evaluate the clinical efficacy and safety of acute hypervolemic hemodilution (AHH) in posterior spinal fusion surgery in children.


METHODS
36 children with scoliosis ASA I approximately II, receive of posterior spinal fusion, were randomly divided into 2 equal groups: AHH group, transfused with hydroxyethyl starch 130/0.4 and sodium chloride (Voluven) 12 ml/kg at the speed of 0.3 approximately 0.4 mlxkg(-1)xmin(-1) (for 30 approximately 40 min) through internal jugular vein before operation so as to keep the hemodilution (Hb) status during operation, and control (CNT) group. During operation when the Hb was <80 g/L or the hematocrit was < 25% blood transfusion was conducted to maintain the Hct > 25%.


RESULTS
There was no significant difference in intra-operative blood loss between these 2 groups. The Hb one day after operation of the AHH group was (89 +/- 12) g/L, significantly lower than that immediately after operation [(98 +/- 10) g/L, P < 0.05]. The Hb one day after operation of the CNT group was (92 +/- 22) g/L, significantly lower than that immediately after operation [(94 +/- 13) g/L, P < 0.05]. However, there were not significant differences in the Hb values between the AHH and CNT groups (all P > 0.05). Both groups received intra-operative transfusion during operation. The amount of transfused red blood cells and fresh frozen plasma of the AHH group were (18 +/- 4) ml/kg and (3.5 +/- 1.1) ml/kg respectively, both significantly lower than those of the CNT group [(28 +/- 11) and (5.8 +/- 1.8) ml/kg respectively, both P < 0.05].


CONCLUSIONS
Able to reduce intra-operative blood transfusion and medical expense, AHH can be used safely and effectively in posterior spine fusion in children.
Chen
Yi-qi
YQ
Department of Anesthesiology, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai 200127, China.
Chen
Yu
Y
Ji
Chen-song
CS
Gu
Hong-bin
HB
Bai
Jie
J
D000293:Adolescent; D000328:Adult; D001810:Blood Volume; D002648:Child; D005260:Female; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D008297:Male; D010952:Plasma Substitutes / Q000008:administration & dosage; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*
D010952:Plasma Substitutes