A randomized trial comparing acute normovolemic hemodilution and preoperative autologous blood donation in total hip arthroplasty

Citation
Lt. Goodnough et al., A randomized trial comparing acute normovolemic hemodilution and preoperative autologous blood donation in total hip arthroplasty, TRANSFUSION, 40(9), 2000, pp. 1054-1057
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology,"Cardiovascular & Hematology Research
Journal title
TRANSFUSION
ISSN journal
0041-1132 → ACNP
Volume
40
Issue
9
Year of publication
2000
Pages
1054 - 1057
Database
ISI
SICI code
0041-1132(200009)40:9<1054:ARTCAN>2.0.ZU;2-U
Abstract
BACKGROUND: The value of acute normovolemic hemodilution (ANH) as compared to preoperative autologous blood donation (PABD) in orthopedic surgery is u nknown. Therefore, a prospective, randomized study was conducted to compare these techniques in patients undergoing primary total hip arthroplasty. STUDY DESIGN AND METHODS: ANH patients underwent phlebotomy for up to 3 uni ts, or to a target Hct level of 28 percent after induction of anesthesia. P ABD patients were asked to donate up to 3 units before admission. RESULTS: Mean baseline Hct levels were not different in ANH and PABD patien ts (39.7 +/- 4.5 vs. 41.8 +/- 3.8%, p = 0.09). No difference was found in a llogeneic blood exposure among ANH and PABD cohorts: 4 (17%) of 23 ANH pati ents received a total of 9 allogeneic blood units, compared to no allogenei c transfusions in the PABD cohort (p = 0.30). Total blood costs associated with ANH were significantly (p<0.05) lower than blood costs associated with PABD ($151 +/- 154 vs. $680 +/- 253, respectively). CONCLUSION: In patients undergoing total hip arthroplasty, ANH is safe, can be considered equivalent to PABD in effectively reducing exposure to allog eneic RBCs, and is less costly than PABD.