Clinical Paper
MedicineEffects of standardized acute normovolemic hemodilution on intraoperative allogeneic blood transfusion in patients undergoing major maxillofacial surgery
Medicine
Section snippets
Methods
From March 2001 to May 2002 patients, presenting at the Clinic for Cranio-Maxillofacial Surgery of the Ludwig-Maximilians University Munich and undergoing major elective maxillofacial surgery with anticipated high surgical blood loss were considered candidates for the study.
Exclusion criteria were: (1) preoperative anemia (Hb<10 g/dl) and/or (2) coagulation disorders (Quick<50%, aPTT>50 s, platelet count<100×103/μl, specific deficiencies of coagulation factors). ANH represents a standard
Results
A total of 124 patients who underwent major elective maxillofacial surgery between March 2001 and May 2002 were included into this study. The patient population consisted of: (1) 40 patients who suffered from dentoskeletal dysgnathia and required surgical correction by bimaxillary osteotomies and, (2) 84 patients who had major malignant head and neck tumor infiltrating the maxilla and/or the mandibule thus requiring vast local tumor resection, immediate reconstruction by microvascular
Discussion
The main findings of the present study are: (1) ANH harvesting a fixed volume of 900 ml (2 units) of whole blood in every patient studied was void of adverse events; (2) the standardization of the hemodilution procedure and particularly the omission of targeting a predefined Hb with ANH made this 2 unit ANH a highly practicable and low time-consuming blood conservation strategy; (3) ANH did not delay the start of the operation; (4) in 49/55 (89%) of the patients having met an intraoperative RBC
Acknowledgements
The authors wish to thank Mrs. Christa Haberl and her anesthesia nursing staff as well as Mrs. Angelika Mellen and her surgical nursing staff for their excellent cooperation.
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