Property | Value |
Name | Practical limits of acute normovolemic hemodilution - Status and future prospects in major maxillofacial surgery |
Description | Original article:- Oral & Maxillofacial Surgery Khaji. Shahanavaj. I* Lecturer, Department of Oral & Maxillofacial Surgery, Tatyasaheb Kore Dental College & Research Centre, Mahatma gandhi hospital campus, New Pargaon- 416137. Kolhapur , Maharastra,India.
Abstract:- Background and objectives: In the last 15 years, the perception of transfusion of allogeneic blood in the surgical setting has moved from a benign intervention, sometimes life-saving, to an outcome to be avoided. The risks associated with allogenic blood transfusion are increasing recognized. Since then, an extensive literature has developed on the indications for, risks of, and alternatives to transfusion of allogeneic blood. The purpose of this study is to evaluate the effects & practical Limits of acute standardized normovolemic hemodilution in patients undergoing elective major maxillofacial surgery. Patients and methods: A total of 15 patients (7 Males, 8 Females, with age ranging from 17-30 years) undergoing elective major oral surgical procedures were randomly assigned for study evaluation. Following induction of general anesthesia, sequestration of 3-5mg/kg of fresh autologous blood was withdrawn anesthetist’s supervision. Blood was collected from peripheral venous lines into bags containing citrate-phosphate-dextrose-adenine-1 anticoagulant, labeled according to published guidelines and replaced simultaneously with a peripheral infusion of crystalloids at volume ratio. Transfusion requirements & post operative complications were recorded on the medical chart. Results & observations: In none of the patients (n=15) significant complications were evident except for in two patients (13%) who had low hemoglobin values post-operatively which were observed in 1st post-operative day. Two units of allogeneic blood were administered in two patients post-operatively. Retransfusion of ANH blood had no significant effect on clotting variables. Conclusion: In summary, the results of this study demonstrate that a standardized ANH harvesting a fixed volume of 350 – 500 ml of whole blood & not targeting a specific, low post ANH – hemoglobin can be considered as a safe, low time consuming & economic allogeneic blood conservation that could be offered to patients undergoing elective maxillofacial surgery, unless severe contra-indications are present. Meanwhile, further studies are necessary to define the efficacy & benefits of autologous transfusion after major elective surgical procedures. Meanwhile, further prospective clinical trials are needed to define the efficacy & benefits of autologous transfusion in major maxillofacial surgeries.
Keywords:- Acute normovolemic hemodilution (ANH); Isovolemic hemodilution; Autologous blood transfusion; Elective major maxillofacial surgeries.
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Copyright © 2013 Khaji Shahanavaj. I. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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