ABSTRACT
Sixty patients were included in this prospective study to compare the effect of mid and moderate degrees of hemodilution on the homologous blood requirements in major gastro-intestinal surgery. The patients were classified into two groups according to the level of hemodilution [mild [group I] and moderate [group II] degrees]. The target hematocrit [Hct], level planned to be around 32 and 28%, at the start of surgery, then 25 and 22% intraoperative; while Hct of 27% was the postoperative transfusion trigger with transfusion of autologous or homologous units. Hemodilution started at five minutes after anesthesia and re-transfused when the target hematocrit reached with autologous units, then homologous blood. Total anesthesia time was longer in group II and the volume withdrawn by hemodilution was [781 +/- 154 and 1734 +/- 142] in the two groups, respectively. Homologous transfusion was less in group II regarding both patients number [12/30 and 5/30] and blood units number [19 and 7 units] in the two groups, respectively. In the postoperative period, 4/30 and 1/30 patients required transfusion to reach Hct of 27%. On discharge, the hemoglobin levels and platelet count was satisfactory in both groups and platelet count was higher in group II [28.4 +/- 1.9-307.5 +/- 67.7 versus 28.9 +/- 2.8-250.8 +/- 73.4]. The complications occurred can not be attributed to hemodilution per se