Prospective randomized controlled trial of acute normovolaemic haemodilution in major gastrointestinal surgery

Abstract

In this large pragmatic study, ANH did not affect allogeneic transfusion rate in major gastrointestinal surgery. Preoperative haemoglobin, blood loss, and transfusion protocol are the key factors influencing allogeneic transfusion.

Pre-Operative Oral Iron Supplementation Reduces Blood Transfusion in Colorectal Surgery – A Prospective, Randomised, Controlled Trial

“…After establishment of a transfusion protocol, there are three factors which determine transfusion levels: blood loss, starting haemoglobin level, and age. 2,3 Much interest has centred on methods of blood conservation, ranging from blood salvage recovery equipment to pre-operative donation. Unfortunately, recovery is not suitable in malignancy and autologous transfusion is often precluded by pre-existing anaemia secondary to the underlying colonic neoplasm.…”

“…1 Rates of peri-operative transfusion ranging from 20-75% have been reported in patients undergoing colorectal resection. 2,3 Despite innovations in transfusion medicine, peri-operative transfusion of allogeneic blood components has inherent risks including immunomodulation, transmission of disease, allergic reaction, and allo-immunisation. More recently, the introduction of leukocyte-depleted blood has led to an increased cost pressure on health resources.…”

“…2,4,5 Pre-operative anaemia is a frequent finding in this group of surgical patients and accounts for a substantial number of blood transfusions. Defining anaemia as a haemoglobin of less than 13.5 g/dl in men and 11.5 g/dl in women, locally recorded data from the preceding years' 223 surgical colorectal cancer patients demonstrated that 51% of men and 25% of women were anaemic (38% combined) on admission.…”

Incidence and Risk Factors of Intraoperative Adverse Events During Donor Lobectomy for Living-Donor Liver Transplantation: A Retrospective Analysis

“…20 However, there are conflicting data regarding the effectiveness of ANHD for reducing transfusion requirements during liver resection and major gastrointestinal surgery. 12,[20][21][22][23][24][25] After adopting perioperative modifications including more-frequent use of ANHD and in-line fluid warmers-rates of hypothermia, hypotension, transfusions, and overall intraoperative adverse events significantly decreased in our patients. Although it is not possible to extrapolate the presence of a causative relation between adopting perioperative modifications and a significant decrease in the rate of intraoperative adverse events, our findings point toward a beneficial effect for these changes.…”

The Clinical Application of Acute Normovolaemic Haemodilution in Oral and Maxillofacial Surgeries

“…There is minimal preoperative preparation for both, the patient and staff, which makes ANH suitable for both emergency and elective procedures [4].…”