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Thread: Haemodilution

  1. #1
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    Haemodilution

    Can someone please explain in detail exactly how haemodilution works. The various stages, etc. What happens to the blood where it goes, for how long, etc. The more detail the better. Thank you in anticipation

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  3. #2
    While this term may sound intimidating, when broken down it is easy to understand. Normovolemic (normal volume) Hemodilution (blood dilution) is a process that significantly reduces the amount of blood cells lost during surgery. This is how it works: Before surgery ever starts, the surgeon, the anesthesiologist, and other personnel discuss and carefully plan the surgery and blood management.
    Just before the surgeon begins, an anesthesiologist starts an IV in a vein in the arm. Blood is slowly drained inside a closed system. This blood volume is simultaneously replaced with fluid (a combination of water and minerals), so that the amount of liquid in the blood vessels remains constant. This consistency in volume maintains the patient’s vital signs stability. While this process is going on, surgery starts. Inevitably, some blood is lost in the process of surgery. However, since this blood has been diluted, the blood is “thin” or has fewer cells and more liquid (red cells are what physicians normally transfuse the most). In turn, the anesthesiologist returns the blood that was removed and has the ability to give back to the patient fresh, whole, cell-rich blood. There is no chance of clerical error as the blood is never stored and never leaves a closed system, which is in constant contact with the patient’s own circulatory system.
    Many people who refuse transfusions for religious reasons find hemodilution acceptable, since they view it as an extension of their own circulatory system.


  4. #3
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    haemodilution

    Feonix,
    As Leslie stated, the term haemodilution or hemodilution is the dilution of blood by typically a compatible crystalloid solution commonly used during fluid resuscitation in surgery. The process of acute normovolemic hemodilution is a procedure whereby an alloquat of blood is sequestered outside of the body and often still in direct communication with the circulatory system. An equal amount of crystalloid solution is administered to replace the sequestered blood volume to maintain normovolemia. The reasons for this procedure are to reduce the number of circulating cellular and protein components in the blood so that any blood shed during the procedure will have less of these factors lost and to use the sequestered volume to help with coagulation, oxygen carrying capacity and added volume after the procedure is completed. The blood volume of a healthy patient can be sequestered up to 30% in this way. This turns the patient into their own blood bank and reduces the chances of receiving someone else's blood. This is a blood banking procedure that is carried out in the operating room or prior to the operation. The process and regulations for it are covered in the AABB Standards for Perioperative Autologous Blood Collection and Administration, 4th Edition.
    Mark Lucas, MPS, CCP
    Blood Management Consultant

  5. #4
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    Thank you for you reply. You said "blood is sequestered outside of the body and often still in direct communication with the circulatory system" So is there time when the blood flow would be interupted, however short that may be? Or would some doctors interupt it while others may not? As the procedure continues or is coming to an end, what are the final stages?

  6. #5
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    Haemodilution

    The sequestered blood is held in specific volume bags containing a citrated anticoagulant. The bags are connected to a peripheral vein or a central venous catheter and depending on religious beliefs remain in constant connection with the patient or can be removed to another location in the room for convenience of space in the operative field.
    Mark Lucas

  7. #6
    Quote Originally Posted by feonix View Post
    Can someone please explain in detail exactly how haemodilution works. The various stages, etc. What happens to the blood where it goes, for how long, etc. The more detail the better. Thank you in anticipation
    Dr. Paul Loubser has posted a discussion of hemodilution on the wiki.
    Click here: Acute Normovolemic Hemodilution - Noblood
    Joseph T. Malak, MD

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