DIE HYPERVOLAMISCHE HAMODILUTION ALS FREMDBLUTSPARENDE MASSNAHME. EINE EINFACHE ALTERNATIVE ZUR AKUTEN NORMOVOLAMISCHEN HAMODILUTION

Problem: Acute normovolenic hemodilution (ANH) is timeconsuming and complicated, and has only a small effect in reducing the need for homologous blood. A simpler procedure is hypervolemic hemodilution (HHD). In the present prospective, randomized study, HHD is compared with ANH for its blood-saving effect. Study design: Forty-nine patients undergoing total hip replacement were admitted. Group I (ANH): Withdrawal of 15 ml/kg bodyweight autologous blood and isovolemic replacement by hydroxyethyl starch (200/0,5). Group II (HHD): Infusion of 15 ml/kg bodyweight hydroxyethyl starch (200/0.5). Results: No significant differences were found between the groups in terms of Hb, hematocrit and coagulation. The blood loss (intra-operative + drainage losses) was comparable in the two groups at 1274 ± 310 ml (HHD) and 130 ± 335 ml (ANH). During the period under investigation, 66% of the patients in the HHD group and 57% in the ANH group required no homologous blood. Conclusion: HHD is just as effective as ANH for reducing homologous blood requirements, and is much simpler to apply.