Aims: Blood transfusions are often given to surgical patients. This study was designed to assess whether acute normovolaemic haemodilution (ANH) reduces exposure to allogeneic blood, affects clinical outcome and hospital stay, and is feasible in colorectal surgery.
Methods: All ASA 1 and 11 patients undergoing colectomies performed between 1997 and 1999 were identified retrospectively from our colorectal cancer database to ascertain our current peri and postoperative transfusion practice. Twenty-six selected patients subsequently underwent ANH during colectomy surgery. The number of patients and units transfused were identified.
Results: One hundred and twenty-three of 317 (39%) patients identified from our colorectal cancer database were transfused a total of 328 units (median 2, range 1-7). Of the 26 patients undergoing ANH, 4 (15%) were transfused a total of 13 units (median 3, range 2-5). The reduction in number of patients transfused was statistically significant (P=0.017). ANH increased anaesthetic time by a median of 19 min. There were no complications associated with ANH and the median hospital stay was 9 days (range 6-13).
Conclusions: In this pilot study of selected patients, ANH is a feasible and effective method of reducing allogeneic blood exposure in major colorectal surgery. A prospective randomised controlled trial is now urgently required.
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http://dx.doi.org/10.1053/ejso.2002.1286 | DOI Listing |
BMJ Open
January 2025
Department of Anesthesia and Operation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Introduction: Acute normovolaemic haemodilution (ANH) is a perioperative blood management technique involving the removal of whole blood and simultaneous infusion of colloids or crystalloids to achieve haemodilution while maintaining normovolaemia. However, its efficacy in reducing the requirement for perioperative allogeneic blood transfusion remains controversial due to inconsistent findings in the literature. An individualised red cell transfusion strategy, guided by the West China Liu's Score, has demonstrated effectiveness in reducing the need for allogeneic red cell transfusion.
View Article and Find Full Text PDFVox Sang
November 2024
Haematology Division, Centro de Hematologia e Hemoterapia do Ceara - HEMOCE, Fortaleza, Ceará, Brazil.
Background And Objectives: Transfusions are common, but their use is decreasing in some countries as a result of increased risk awareness and the implementation of patient blood management (PBM), an evidence-based approach to optimize patient outcomes. This study aimed to detail the implementation of PBM in a Brazilian state and its impact on transfusion rates and associated costs.
Materials And Methods: The PBM implementation involved several strategies: medical education, haematology consultation services, provision of intravenous iron and other medications, establishment of PBM and perioperative anaemia clinics, cell salvage and acute normovolaemic haemodilution, anaemia reference laboratories and rotational thromboelastometry.
BMC Anesthesiol
March 2023
Department of General Surgery, Xishan People's Hospital of Wuxi city, No. 1128 Dacheng Road, Xishan District, Wuxi, 214105, China.
Background: Perioperative bleeding and allogeneic blood transfusion are generally thought to affect the outcomes of patients. This meta-analysis aimed to determine the benefits and risks of several cardiovascular interventions in patients undergoing hepatectomy.
Methods: In this systematic review and meta-analysis, randomised controlled trials (RCTs) were searched in the Cochrane Library, Medline, Embase, and Web of Science to February 02, 2023.
PLoS One
May 2022
Department of Anaesthesiology, Tokyo Women's Medical University Medical Centre East, Tokyo, Japan.
Coron Artery Dis
January 2022
Department of Cardiothoracic Surgery, Liverpool Heart and Chest.
Emerging evidence suggests surgical outcomes of patients undergoing cardiovascular surgery that refuse autologous transfusion is comparable to those who accept whole blood product transfusions. There are several methods that can be used to minimize blood loss during cardiovascular surgery. These methods can be categorised into pharmacological measures, including the use of erythropoietin, iron and tranexamic acid, surgical techniques, like the use of polysaccharide haemostat, and devices such as those used in acute normovolaemic haemodilution.
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