Preoperative autologous blood donation and acute normovolemic hemodilution affect intraoperative blood loss during sagittal split ramus osteotomy

Abstract

IntroductionThis study aimed to determine the effects of acute normovolemic hemodilution (ANH) using low-molecular-weight hydroxyethyl starch (LMW-HES) on intraoperative blood loss in patients who had received preoperative autologous blood donation (PABD) and had undergone sagittal split ramus osteotomy (SSRO). MethodsPatients who had undergone SSRO were analyzed. All 250 patients received PABD of 400–800mL until 2weeks before surgery. ANH was performed by withdrawing whole blood, which was replaced by the same volume of LMW-HES. ANH was performed in 197 cases for 200mL replacement (ANH-200) and in 5 cases for 400mL replacement (ANH-400); it was not performed in 48 cases (ANH-0). ResultsBlood loss in ANH-200 was greater than that in ANH-0, despite no differences in hemoglobin concentrations at pre- and post-PABD, prothrombin time, activated partial thromboplastin time, fibrinogen and platelet counts between the groups before surgery. Blood loss increased as the total withdrawn blood (sum of PABD and ANH) increased. ConclusionIncreased intraoperative blood loss was associated with total withdrawn blood before the operation as well as ANH.