[Acute normovolemic hemodilution to reduce allogenic blood transfusion in patients undergoing radical cystectomy].
BACKGROUND
Allogenic blood transfusion is associated with a number of well-recognized risks and complications. We report here acute normovolemic hemodilution (ANH) to reduce allogenic blood transfusion during radical cystectomy.


METHODS
Forty five patients (hematocrit > 35%, ASA status I-II) undergoing elective open radical cystectomy were investigated retrospectively by dividing into two groups, namely ANH group (group H; n=25), and control group (group C; n=20). After induction of general anesthesia combined with epidural anesthesia, autologous whole blood (800-1600ml) is collected in a series of collection bags (group H). When hemoglobin level dropped below the trigger (hemoglobin 7-8 g x dl(-1)) during surgery, allogenic blood transfusion (group C) and/or autologous blood transfusion (group H) were given.


RESULTS
No differences in intraoperative blood loss and urine volume between the two groups were observed. Nine patients in group C made use of allogenic blood transfusion (mean 570 ml). In contrast, no patients were given allogenic blood in group H. Two weeks after the operation, there was no difference in hemoglobin concentrations between the two groups and no serious complications occurred in all the patients studied.


CONCLUSIONS
ANH may be effective in reducing the necessity of allogenic blood transfusion during radical cystectomy with a relatively large surgical blood loss.
Ono
Koichi
K
Department of Anesthesia, Nagano Municipal Hospital, Nagano 380-0877.
Shibata
Junpei
J
Tanaka
Toshiyuki
T
Sakamoto
Akiyuki
A
Hasegawa
Jo
J
Tanaka
Satoshi
S
Kitoh
Takeshi
T
Kawamata
Mikito
M
D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D015653:Cystectomy; D005260:Female; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D008297:Male