Prospective randomized study of acute normovolaemic haemodilution versus induced hypotension on haemostatic markers and transfusion requirements in major orthopaedic surgery

ABSTRACT

Thirty patients scheduled for orthopedic surgery of the hip, femur or pelvis for sepsis or malignant tumors, all under general anesthesia, were randomly allocated to one of two groups Acute normovolemic hemodilution group [ANH group] and hypotensive group [H group]. ANH was started after induction of general anesthesia. In H group, hypotension was induced and maintained using esmolol. Hemoglobin [Hb] and hematocrit [Hct] measures as well as coagulation variables were measured during perioperative period. Total blood loss of each patient was evaluated. The results revealed that homologous transfusion requirements were noted. In ANH group, Hb and Hct values were significantly decreased intra and postoperatively compared to H group. ANH caused significant decrease of platelet count and prolongation of activated partial thromboplastin time [aPTT] intra and postoperatively compared to H group. Significant more volume was infused in ANH group than H group. Patients in H group had significant lower blood loss and needed significant less allogenic blood transfusion