| Adjuncts to liver surgery: is acute normovolemic hemodilution useful for major hepatic resections? | |
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MedLine Citation:
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PMID: 19845184 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Shishir K Maithel; William R Jarnagin |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Advances in surgery Volume: 43 ISSN: 0065-3411 ISO Abbreviation: Adv Surg Publication Date: 2009 |
Date Detail:
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Created Date: 2009-10-22 Completed Date: 2009-12-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0045335 Medline TA: Adv Surg Country: United States |
Other Details:
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Languages: eng Pagination: 259-68 Citation Subset: IM |
Affiliation:
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Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue C-887, New York, NY 10065, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Hemodilution
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methods* Hepatectomy / methods* Humans Liver Diseases / surgery Preoperative Care / methods* Treatment Outcome |
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