Application of Hypervolemic Hemodilution (HH) to Avoid Blood Transfusion

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 13; no. 7; pp. 648 - 653
• Main Authors: FUJII, Masayuki, OKUAKI, Akira, KONISHI, Akio, KIKUCHI, Keiko, TAMII, Hiromasa
• Format: Journal Article
• Language: English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 1993
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.13.648

To avoid blood transfusion, we carried out hypervolemic hemodilution (HH) by rapid infusion of colloid solution without blood withdrawal in anemic patients. Nine patients who had Hb of less than 11g/dl, and normal cardiac and renal functions, underwent HH with Ringer's lactate and HES, and with hypotensive anesthesia induced by nitroglycerin. This procedure made it possible to avoid blood transfusion for all patients without any complications or any abnormalities in the blood coagulation system. The minimum value of Hct was 23% on avarage. We concluded that this preoperative HH was a very useful technique for avoiding blood transfusions in anemic patients. During acute hemodilution, however, excessive volume loading was associated with significant increases in CVP, PAP and PCWP. We must therefore select the operative cases who can most safely undergo HH, and should take scrupulous care concerning the sort of anesthetic technique and vasodilating therapy conducted during HH.