A randomized trial comparing acute normovolemic hemodilution and preoperative autologous blood donation in total hip arthroplasty

Lawrence T. Goodnough, George J. Despotis, Kurt Merkel, Terri G. Monk

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

BACKGROUND: The value of acute normovolemic hemodilution (ANH) as compared to preoperative autologous blood donation (PABD) in orthopedic surgery is unknown. Therefore, a prospective, randomized study was conducted to compare these techniques in patients undergoing primary total hip arthroplasty. STUDY DESIGN AND METHODS: ANH patients underwent phlebotomy for up to 3 units, or to a target Hct level of 28 percent after induction of anesthesia. PABD patients were asked to donate up to 3 units before admission. RESULTS: Mean baseline Hct levels were not different in ANH and PABD patients (39.7 ± 4.5 vs. 41.8 ± 3.8%, p = 0.09). No difference was found in allogeneic blood exposure among ANH and PABD cohorts: 4 (17%) of 23 ANH patients received a total of 9 allogeneic blood units, compared to no allogeneic transfusions in the PABD cohort (p = 0.30). Total blood costs associated with ANH were significantly (p<0.05) lower than blood costs associated with PABD ($151 ± 154 vs. $680 ± 253, respectively). CONCLUSION: In patients undergoing total hip arthroplasty, ANH is safe, can be considered equivalent to PABD in effectively reducing exposure to allogeneic RBCs, and is less costly than PABD.

Original languageEnglish
Pages (from-to)1054-1057
Number of pages4
JournalTransfusion
Volume40
Issue number9
DOIs
StatePublished - Sep 23 2000

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