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Thread: Use of Hypervolemic hemodilution in spinal fusion

  1. #1
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    Use of Hypervolemic hemodilution in spinal fusion

    Can Hypervolemic hemodilution be used as an alternative to a blood transfusion, Cell Saver, or Normovolemic Hemodilution in spinal fusion surgery?
    I am a Jehovahs Witness and the cell saver and normovolemic hemodilution are conscience matters for us, and my personal conscience does not feel comfortable with the cell saver or normovolemic hemodilution.
    However I have basilar invagination and may have to undergo a complete fusion of my cervicle spine, so can hypervolemic hemodilution be used as a safe alternative in this type of surgery?
    Has anyone heard of a similar surgery being performed successfully with this technique.
    Also am I correct that hypervolemic hemodilution does not withdraw and reinfuse any of my blood, but only adds fluid to my blood to dilute it?

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  3. #2

    hypervolemic Hemodilution

    Answer - yes, it can. Acute Hypervolemic Hemodilution (AHH) is quite simple for the anesthesiologist to do, in that one simply dilutes the intravascular compartment with some form of asanguinous fluid such as normal saline, lactated Ringer's or hetastarch. As long as you don't have some form of CHF or other cardiac problem, you should be able to tolerate the extra volume. Only problem, and not knowing where you live, AHH seems particularly popular in the UK. Most American anesthesiologists and surgeons are not familar with it, or do not believe that it is efficacious. Hope this helps.

    Quote Originally Posted by hanznelson19 View Post
    Can Hypervolemic hemodilution be used as an alternative to a blood transfusion, Cell Saver, or Normovolemic Hemodilution in spinal fusion surgery?
    I am a Jehovahs Witness and the cell saver and normovolemic hemodilution are conscience matters for us, and my personal conscience does not feel comfortable with the cell saver or normovolemic hemodilution. However I have basilar invagination and may have to undergo a complete fusion of my cervicle spine, so can hypervolemic hemodilution be used as a safe alternative in this type of surgery? Has anyone heard of a similar surgery being performed successfully with this technique. Also am I correct that hypervolemic hemodilution does not withdraw and reinfuse any of my blood, but only adds fluid to my blood to dilute it?
    Paul G. Loubser, MD
    National Cardiac Anesthesia Consultants, PA

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