Acute normovolaemic haemodilution for gynaecological surgery in Korle Bu Teachning Hospital: how feasible it is?

Abstract

Transfusion of allogenic blood and blood products is associated with the risk of infections such as Hepatitis A, B and C and HIV/AIDS. To minimize these risks various forms of autologous blood transfusion techniques e.g. acute normovolaemic haemodilution (ANH), are increasingly being used. Seventy-four patients scheduled for hysterectomy or myomectomy were enrolled for the study after institutional and informed consent. One unit of blood was removed from the patients under anaesthesia and before surgery commenced. Blood volume replacement i.e. haemodilution was achieved with available crystalloids plus gelofusine or hydroxy ethyl starch (HES). Twenty-one patients had erythropoietin (EPO) therapy as part of their preparation. The mean age of the patients was 41.5 + 8.2 years and the mean preoperative haemoglobin and haematocrit were 12.4 + 1.0g/dl and 37.8% respectively. Mean post-haemodilution haemoglobin was 10.6 + 0.8g/dl with a haematocrit of 32.2 + 3.0g/dl. The mean postoperative haemoglobin was 10.7 + 1.0g/dl and the haematocrit 32.4 + 3.0%. Mean blood loss was 841 + 321ml with the bigger losses observed in those patients who had both hysterectomy and apronectomy. There were no untoward ECG or haemodynamic changes. It was concluded that acute ANH for gynaecological surgery is safe, simple and feasible to perform in this environment at minimal cost