Adjuncts to liver surgery: is acute normovolemic hemodilution useful for major hepatic resections? Review uri icon

Overview

abstract

  • For patients undergoing major hepatic resection, acute normovolemic hemodilution is a safe technique that effectively reduces allogeneic red blood cell transfusions. In the recent prospective randomized controlled trial completed at MSKCC, there was no difference in the extent of resection, intraoperative blood loss, operative time, incidence and grade of complications, or length of hospital stay between patients who underwent ANH versus standardintraoperative management. Although ANH does reduce the rate o f allogeneic red blood cell transfusions in patients undergoing major hepatectomy, its benefit is particularly pronounced in patients who have significant operative blood loss (i.e., >800 mL). In these patients, the benefit of ANH extends also to the transfusion of FFP. Thus, ANH should be considered for routine use in patients undergoing major hepatectomy who have an expected considerable blood loss. However, given the relatively low transfusion rate overall, future efforts should be directed at preoperatively identifying patients most likely to benefit from ANH.

publication date

  • January 1, 2009

Research

keywords

  • Hemodilution
  • Hepatectomy
  • Preoperative Care

Identity

Scopus Document Identifier

  • 70350044455

Digital Object Identifier (DOI)

  • 10.1016/j.yasu.2009.02.012

PubMed ID

  • 19845184

Additional Document Info

volume

  • 43