[Preoperative normovolemic hemodilution using erythropheresis].

Normovolaemic haemodilution was carried out by erythropheresis by the Blood Bank, 24 to 72 yours before surgery, using a plasmapheresis device. A special disposable haemodilution kit was used, with one plasma and three red cell collection bags and CPD as anticoagulant. Plasma was replaced by 4% albumin. One to 4 red cell packs with 75% haematocrit was obtained and stored for 10 days. This technique is indicated for surgery with an expected blood loss between 1,000 and 1,500 ml, or when the patient cannot be included in a preoperative blood donation programme. The contra-indications are the same as those of intentional normovolaemic haemodilution. This technique has been used in 101 patients due to undergo orthopaedic surgery. Compared with standard haemodilution bags, the advantages of this technique are the excellent asepsis of this product, its 10 days storage and high haematocrit, and the absence of anaesthetic drugs within the bags as well. This technique does not interfere with haemodynamic conditions during anaesthesia; it saves time for both anaesthetists and surgeons. In the authors' experience, this technique has in part replaced the more usual technique.