Abstract
Justifications: Perioperative allogeneic blood transfusion can be reduced or even completely avoided by using a set of different strategies: meticulous hemostasis, the use of pharmaceutical agents that assist in the process of coagulation/ fibrinolysis, the use of blood substitutes, induced hypotension, preoperative autologous blood donation, collection and reinfusion of autologous blood during the operation, as well as from acute normovolemic hemodilution (ANH). Contents: ANH consists of taking a percentage of the patient’s blood volume and a concurrent infusion of acellular fluids in order to maintain normovolemia. As a consequence, a hemodiluted patient will lose less blood cells for each blood volume that is lost during the surgical procedure. The aim of this study is to clarify doubts and provide practical information relative to the procedure of ANH through the author’s own experiences as well as literary examples. Conclusions: ANH is an easy and cheap technique performed during the intraoperative period useful to reduce the use of hemoderivatives.
Highlights
Acute normovolemic hemodilution (ANH) has been used since the 60’s and its aim is to reduce or even avoid the need for transfusion of homologous blood during the perioperative period [1,2,3]
Justifications: Perioperative allogeneic blood transfusion can be reduced or even completely avoided by using a set of different strategies: meticulous hemostasis, the use of pharmaceutical agents that assist in the process of coagulation/ fibrinolysis, the use of blood substitutes, induced hypotension, preoperative autologous blood donation, collection and reinfusion of autologous blood during the operation, as well as from acute normovolemic hemodilution (ANH)
ANH is an easy and cheap technique performed during the intraoperative period useful to reduce the use of hemoderivatives
Summary
Acute normovolemic hemodilution (ANH) has been used since the 60’s and its aim is to reduce or even avoid the need for transfusion of homologous blood during the perioperative period [1,2,3]. It consists of withdrawing a percentage blood volume from the patient and simultaneous infusion of acellular fluids in order to maintain the volume. This procedure will make the patient anemic, he will remain normovolemically and hemodynamically stable [4]. While there are fine meta-analysis on this subject [3,6] the main point of this study is to elicit common questions on the subject beyond provide some practical strategies based on recent studies and the experience of the authors
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