Acute normovolaemic haemodilution

  • C. Bandeira Margarido
  • D. Aya Otsuki
  • J. O. C. Auler
Conference paper


The potential risk of transmission of infectious diseases and of other adverse effects, including transfusion reaction, immunosuppression, transfusion-related acute lung injury, has reinforced a general reappraisal of transfusion and a critical analysis of its benefits, risks and costs in the clinical and surgical settings. At the same time, research into alternatives to allogeneic red blood cell transfusion and physiological effects of lower haemoglobin levels has been developed. Critically ill patients in intensive care units usually require red cell transfusion to compensate anaemia caused by bleeding or the need to augment oxygen delivery. Unfortunately, these critically ill patients may be more susceptible than others to the immunosuppressive complications of transfusion.


Hydroxyethyl Starch Major Liver Resection Improve Blood Flow Cell Salvage Preoperative Autologous Blood Donation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Varat MA, Adolph RJ, Fowler NO (1972) Cardiovascular effects of anemia. Am Heart J 83: 415–426PubMedCrossRefGoogle Scholar
  2. 2.
    Martin E, Hansen E, Peter K (1987) Acute limited normovolemic hemodilution: a method for avoiding homologous transfusion. World J Surg 11: 53–59PubMedCrossRefGoogle Scholar
  3. 3.
    Fahmy NR, Chandler HP, Patel DJ et al (1980) Hemodynamics and oxygen availability during acute hemodilution in conscious man (abstract). Anesthesiology 53 (Suppl): 584Google Scholar
  4. 4.
    Gallagher JD (1995) Hemodilution: physiology and limits of anemia. In: Lake CL, Moore RA (eds) Blood hemostasis, transfusion and alternatives in the perioperative period. Raven Press, New York, pp 345–380Google Scholar
  5. 5.
    Doss DN, Estafanous FG, Ferrario CM et al (1995) Mechanism of systemic vasodilation during normovolemic hemodilution. Anesth Analg 81: 30–34PubMedGoogle Scholar
  6. 6.
    Ickx BE, Rigolet M, Van der Linden PJ (2000) Cardiovascular and metabolic response to acute normovolemic anemia. Effects of anesthesia. Anesthesiology 93: 1011–1016PubMedCrossRefGoogle Scholar
  7. 7.
    Spahn DR, Casutt M (2000) Eliminating blood transfusions. Anesthesiology 93: 242–255PubMedCrossRefGoogle Scholar
  8. 8.
    Monk TG, Goodnough LT (1998) Acute normovolemic hemodilution. Clin Orthop 357: 74–81PubMedCrossRefGoogle Scholar
  9. 9.
    Helm RE, Klemperer JD, Rosengart TK et al (1996) Intraoperative autologous blood donation preserves red cell mass but does not decrease postoperative bleeding. Ann Thorac Surg 62: 1431–1441PubMedCrossRefGoogle Scholar
  10. 10.
    Kochamba GS, Pfeffer TA, Sintek CF et al (1996) Intraoperative autotransfusion reduces blood loss after cardiopulmonary bypass. Ann Thorac Surg 61: 900–903PubMedCrossRefGoogle Scholar
  11. 11.
    Kahraman S, Altunkaya H, Celebioglu B et al (1997) The effect of acute normovolemic hemodilution on homologous blood requirements and total estimated red blood cell volume lost. Acta Anaesthesiol Scand 41: 614–617PubMedCrossRefGoogle Scholar
  12. 12.
    Bryson GL, Laupacis A, Wells GA (1998) Does acute normovolemic hemodilution reduce perioperative allogenic transfusion? A meta-analysis. Anesth Analg 86: 9–15PubMedGoogle Scholar
  13. 13.
    Matot I, Scheinin O, Jurim O et al (2002) Effectiveness of acute normovolemic hemodilution to minimize allogenic blood transfusion in major liver resections. Anesthesiology 97: 794–800PubMedCrossRefGoogle Scholar
  14. 14.
    Auler JOC (2001) Haemodilution in clinical anesthesia. Minerva Anestesiol 67: 355–357PubMedGoogle Scholar
  15. 15.
    American college of physicians (1992) Practice strategies for elective red blood cell transfusion. Ann Intern Med 116: 403–406Google Scholar
  16. 16.
    Hebert PC, Wells G, Blajchman MA et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340: 409–417PubMedCrossRefGoogle Scholar
  17. 17.
    Hebert PC, Yetisir E, Martin C et al (2001) Is a low transfusion threshold safe in critically ill patients with cardiovascular diseases? Crit Care Med 29: 227–234PubMedCrossRefGoogle Scholar
  18. 18.
    Wu WC, Rathore SS, Wang Y et al (2001) Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 345: 1230–1236PubMedCrossRefGoogle Scholar
  19. 19.
    Weiskopf RB (2002) Hemodilution and candles. Anesthesiology 97: 773–775PubMedCrossRefGoogle Scholar
  20. 20.
    Petrovitch CT, Drumond JC (2001) Hemotherapy and hemostasis. In: Barash PJ, Cullen BF, Stoelting RK (eds) Clinical anesthesia, 4th edn Lippincott/Williams and Wilkins, Philadelphia, pp 201–236Google Scholar
  21. 21.
    Janjua N, Mayer AS (2003) Cerebral vasoespasm after subarachnoid hemorrhage. Curr Opin Crit Care 9: 113–119PubMedCrossRefGoogle Scholar
  22. 22.
    Adams PH, Adams RJ, Brott T et al (2003) Guidelines for the early management of patients with ischemic stroke. A scientific statement from the Stroke Council of the American Stroke Association. Stroke 34: 1056–1083PubMedCrossRefGoogle Scholar
  23. 23.
    Morgan GE, Mikhail MS, Murray MJ (2001) Clinical anesthesiology, 3th edn McGraw-Hill/Appleton & Lange, Philadelphia 433–471Google Scholar
  24. 24.
    Fantoni DT (2001) Hemodilution in experimental setting. Minerva Anestesiol 67: 351–354PubMedGoogle Scholar
  25. 25.
    Fraga AO (2002) Acute Normovolemic Hemodilution with Ringer’s lactate or hydroxyethyl starch 6% in dogs: cardiovascular, metabolic, respiratory and histopathological evaluation. Thesis, University of Sao Paulo Medical SchoolGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • C. Bandeira Margarido
  • D. Aya Otsuki
  • J. O. C. Auler

There are no affiliations available

Personalised recommendations