Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Acute normovolemic hemodilution for major hepatic resection

A trial of acute normovolemic hemodilution reported in the latest issue of Annals of Surgery compares standard intraoperative management in patients undergoing major hepatic resection.

News image

fiogf49gjkf04

Hepatic resection is the most effective treatment for many malignant and benign conditions affecting the liver and biliary tree.

Despite improvements, major partial hepatectomy can be associated with considerable blood loss and transfusion requirements.

Transfusion of allogeneic blood products, although potentially life-saving, is associated with many potential complications.

Dr William Jarnagin and colleagues determined if acute normovolemic hemodilution, an established blood conservation technique, reduces the requirement for allogeneic red cell transfusions in patients undergoing major hepatic resection.

The team prospectively randomized 130 patients, undergoing major hepatic resection to undergo either acute normovolemic hemodilution or standard anesthetic management.

Acute normovolemic hemodilution reduced the allogeneic red cell transfusion rate in 18%
Annals of Surgery

In the acute normovolemic hemodilution group, intraoperative blood collection was performed to a target hemoglobin of 8.0 g/dL.

Low central venous pressure anesthetic technique was used intraoperatively for both groups.

A standardized transfusion protocol was applied to all patients intraoperatively and throughout the hospital stay.

The researchers randomized 63 patients to acute normovolemic hemodilution, and 67 to standard anesthetic management from 2004 to 2007.

Demographics, diagnoses, liver function, extent of resection, intraoperative blood loss, operative time, incidence and grade of complications, and length of hospital stay were similar between the 2 groups.

The team found that acute normovolemic hemodilution reduced the overall allogeneic red cell transfusion rate by 50% compared with standard anesthetic management.

Acute normovolemic hemodilution patients were less often transfused intraoperatively compared with the standard anesthetic management group.

The research team noted that acute normovolemic hemodilution patients had higher postoperative hemoglobin levels, and tended to require fewer red cell units overall.

In patients with intraoperative blood loss 800 mL or more, acute normovolemic hemodilution reduced not only the allogeneic red cell transfusion rate in 18% vs 42% with standard anesthetic management.

In patients with intraoperative blood loss 800 mL or more, acute normovolemic hemodilution reduced the proportion of patients requiring fresh frozen plasma.

Dr Jarnagin’s team concluded, “For patients undergoing major liver resection, acute normovolemic hemodilution is safe, effectively reduces the need for allogeneic transfusions, and should be considered for routine use.”

“Given the modest transfusion rate in the standard anesthetic management arm, future efforts should attempt to target acute normovolemic hemodilution use to patients most likely to benefit.”

Annals of Surgery 2008: 248(3): 360-9


18 September 2008

Go to top of page Email this page Email this page to a colleague

 22 February 2018 
Outcomes with Crohn’s after infliximab withdrawal
 22 February 2018 
Elderly onset of IBD

 22 February 2018 
Autophagy enhancers
 21 February 2018 
Management of hemorrhoids in the USA
 21 February 2018 
Adalimumab and infliximab in biologic-naïve Crohn's
 21 February 2018 
Cystic fibrosis and colorectal cancer
 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us