Much concern has been raised in the past decade regarding the risk of transmitting infectious disease through allogenic blood transfusion (BT) and the rising cost of stringent donor screening. Acute normovolemic hemodilution (ANH) is currently viewed as an alternative procedure to standard BT. It involved the reduction of a patient's red blood cell (RBC) mass by removing whole blood and replacing the extracted volume with crystalloids. The concentrated blood is returned to the patient postoperatively or when the surgical bleeding has been controlled. In principle, ANH can decrease the amount of RBCs lost during surgery and avoid or decrease his exposure to allogeneic blood.
Since the inception of this technology in the mid-1980s, there has been limited use of ANH in the country. This pilot study aims to explore and describe the safety and efficacy of ANH in reducing or even preventing the need for allogeneic blood transfusion among elective surgery patients at the Baguio General Hospital. Ten patients from the surgical charity ward participated from October to November 2003. Hemodynamic parameters such as pre-and postoperative hemotocrit, oxygen saturation, vital signs (heart rate, respiratory rate, temperature and blood pressure), electrocardiographic monitoring and subjective feedback were monitored.
All 10 patients tolerated 1 liter of hemodilution with stable vital signs and favorable subjective feedback. Oxygen saturation was unaffected and ranged rom 98% to 100%. No allogeneic blood was transfused in all 10 subjects. The study demonstrated that ANH effectively reduces patient exposure to allogeneic blood products without compromising hemodynamic status. Further studies (e.g., on cost efficacy and with direst comparison vs a control group) are recommended to establish the potential benefits of ANH as a viable alternative to allogenic BT.