Impact of Acute Normovolemic Hemodilution on Requirement for Blood Transfusion in Patients Undergoing Major Head and Neck Surgeries
Roniya Ann Roy, Sunil Rajan, Gayathri Sreekumar, Haleel Fazil, Lokeshshiva Arul, Jerry PaulBackground:
To minimize complications of blood transfusion, alternative approaches like autologous transfusion have been introduced.
Aim of Study:
To evaluate if acute normovolemic hemodilution (ANH) reduces allogeneic blood transfusion requirements compared to standard care in patients undergoing head and neck surgeries with anticipated major blood loss. Hemodynamic parameters, inotrope requirements, adverse events associated with blood transfusion, and length of hospital stay were also compared between groups.
Settings and Design:
This was a prospective, randomized controlled, open-label study.
Methods:
A total of 48 patients were recruited and randomly assigned to either the ANH group (Group A) or the control group (Group B). In Group A, a standard blood unit was withdrawn and replaced with Ringer’s lactate. The collected blood was stored in Citrate Phosphate Dextrose Adenine Solution, USP buffer and retransfused as needed. Vital signs were continuously monitored. Volume replacement was maintained with Ringer’s lactate or other fluids. In Group B, no ANH was performed. Intraoperative blood loss was calculated, and arterial blood gas analysis, hemoglobin (Hb) measurements, and complete blood count were performed.
Results:
The need for allogenic blood transfusion was significantly lower in Group A compared to Group B (20.33% vs. 62.5%,
Conclusion:
The need for allogenic blood transfusion after ANH was significantly lower compared with patients receiving standard care with homologous blood transfusion.