Acute normovolaemic haemodilution

Improved anesthesiological and surgical care has resulted in a progressively declining need for allogeneic blood transfusion. In infants with craniosynostosis, however, allogeneic blood transfusion is still performed as a routine procedure. In the present paper, the authors describe a protocol they have devised with the aim of limiting or even avoiding allogeneic blood transfusion even in very young patients, consequently avoiding the risks of infective or immunologic reactions associated with the procedure. The protocol is based on stimulation of the hematopoietic system with erythropoietin, selection of an appropriate age for operation when a favorable balance between fetal and adult-type hemoglobin is established (that is after 4-6 months), preoperative preparation of the autologous blood supply, and intraoperative blood salvage.

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“…• Acute preoperative normovolemic hemodilution (APNH) [25,45,48,51]; • Intraoperative blood salvage (IOBS) [19,58,70,74].…”

Section: The Protocolmentioning

confidence: 99%

"No Allogeneic Blood Transfusion" protocol for the surgical correction of craniosynostoses

Velardi

Chirico

Rocco

et al. 1998

Child's Nervous System

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“…However, progressive hemodilution without supplemental O 2 or respiratory support eventually impairs circulatory dynamics, and the resulting fall in blood pressure further compromises tissue oxygenation induced by hemodilution. Because of the concern of producing hypoxia during restoration of circulatory volume with erythrocyte-free solutions, the use of hemodilution is restricted to Hct of 20 -30% (13,58). However, successful case reports of extreme hemodilution indicate a wide margin between current practice and more extensive, but still safe, hemodilution (11,17).…”

Section: Resultsmentioning

confidence: 99%

Subcutaneous Po₂ as an index of the physiological limits for hemodilution in the rat

Pearce¹,

Waasdorp²,

Hufnagel³

et al. 2005

Journal of Applied Physiology

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“…The blood is then transfused after CPB is completed. Few recent studies exist to evaluate this technique [134,135].…”

Section: Hemodilutionmentioning

confidence: 99%

Cardiopulmonary Bypass

McLean¹,

Lombardi²,

Pearl³

2008

Cardiovascular Pediatric Critical Illness and Injury

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Acute normovolaemic haemodilution

Cited by 16 publications

References 31 publications

"No Allogeneic Blood Transfusion" protocol for the surgical correction of craniosynostoses

"No Allogeneic Blood Transfusion" protocol for the surgical correction of craniosynostoses

Subcutaneous Po₂ as an index of the physiological limits for hemodilution in the rat

Cardiopulmonary Bypass

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Acute normovolaemic haemodilution

Cited by 16 publications

References 31 publications

"No Allogeneic Blood Transfusion" protocol for the surgical correction of craniosynostoses

"No Allogeneic Blood Transfusion" protocol for the surgical correction of craniosynostoses

Subcutaneous Po2 as an index of the physiological limits for hemodilution in the rat

Cardiopulmonary Bypass

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About

Subcutaneous Po₂ as an index of the physiological limits for hemodilution in the rat