Document Detail


Adjuncts to liver surgery: is acute normovolemic hemodilution useful for major hepatic resections?
MedLine Citation:
PMID:  19845184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
For patients undergoing major hepatic resection, acute normovolemic hemodilution is a safe technique that effectively reduces allogeneic red blood cell transfusions. In the recent prospective randomized controlled trial completed at MSKCC, there was no difference in the extent of resection, intraoperative blood loss, operative time, incidence and grade of complications, or length of hospital stay between patients who underwent ANH versus standardintraoperative management. Although ANH does reduce the rate o f allogeneic red blood cell transfusions in patients undergoing major hepatectomy, its benefit is particularly pronounced in patients who have significant operative blood loss (i.e., >800 mL). In these patients, the benefit of ANH extends also to the transfusion of FFP. Thus, ANH should be considered for routine use in patients undergoing major hepatectomy who have an expected considerable blood loss. However, given the relatively low transfusion rate overall, future efforts should be directed at preoperatively identifying patients most likely to benefit from ANH.
Authors:
Shishir K Maithel; William R Jarnagin
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Advances in surgery     Volume:  43     ISSN:  0065-3411     ISO Abbreviation:  Adv Surg     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-22     Completed Date:  2009-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045335     Medline TA:  Adv Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-68     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue C-887, New York, NY 10065, USA.
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MeSH Terms
Descriptor/Qualifier:
Hemodilution / methods*
Hepatectomy / methods*
Humans
Liver Diseases / surgery
Preoperative Care / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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