Acute normovolemic hemodilution as an alternative to hardware-assisted blood-saving techniques in operations for the correction of spinal deformities in patients with grade III-IV scoliosis

There were 45 adolescent patients with scoliosis of III-IV degree who underwent operative correction of the spine deformity by Cotrel-Dubousset system. Intraoperatively 26 patients received autologous shed blood reinfusion collected from wound drainage (mean 17.3+5.6 ml/kg), no donor erythrocytic mass was transfused. In 19 patients presurgical normovolemic hemodilution with 500 ml blood donation was performed. Reinfusion of that blood as well as the transfusion of donor washed off erythrocytes (mean 13.8+1.3 ml/kg) were performed at the peak of blood loss. Marked differences in patients’ condition were noted neither during surgical intervention nor in the postoperative period. It was concluded that normovolemic hemodilution in combination with transfusion of donor washed off erythrocytes may be the alternative to reinfusion of autologous shed blood if the later could not be performed.