Acute Normovolemic Hemodilution in Patients Undergoing Elective Major Surgery

Abstract

Efficacy of acute normovolemic hemodilution in patients undergoing elective major surgery was studied with the aim to evaluate optimum technique, safety and utility in the service. Forty adult patients undergoing elective major surgery, who were in ASA GD I with preoperative haemoglobin more than 10.0g% were included in this study after a detailed explanation of the procedure and obtaining consent. 350-700 ml of patients' blood was collected before induction of anaesthesia and was kept in the operation theatre at room temperature. This was followed by rapid infusion of crystalloid calculated at the rate of 3ml for every ml of blood withdrawn. Intraoperative blood loss, serial haemoglobin assessment, change in pulse rate, blood pressure, SpO and urine output were carefully monitored. The blood was reinfused once haemostasis was secured at the end of surgery. All the vital parameters were maintained within normal limits throughout the procedure. This simple, easy and inexpensive technique was found to be very useful in obviating the necessity of other forms of blood transfusion and preventing all transfusion related hazards. It was found that this method has an important role in patients with uncommon blood groups and has an excellent patient acceptability. This technique has an important role in peripheral service hospitals, where formal blood bank facilities do not exist.