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  • Title: Preoperative autologous blood donation - part I. Only two clinical parameters determine efficacy of the autologous predeposit.
    Author: Singbartl G.
    Journal: Minerva Anestesiol; 2007 Mar; 73(3):143-51. PubMed ID: 17384572.
    Abstract:
    AIM: To improve efficacy of preoperative autologous blood donation (i.e. increase in total RBC-mass) it is important to know those clinical parameters that are of decisive impact for it. METHODS: Prospective study in 704 patients scheduled for major orthopaedic surgery. Donation of either one or two separately collected RBC-units, and calculation of increase in RBC-mass by the HCT-method. Qualitative statistical analysis by multiple univariate analysis of variances, correlation analysis with Pearson, multiple linear regression analysis. Quantitative statistical analysis by t-/U-test; P<0.01(n >or= 100), and P<0.05 (n <100), respectively. RESULTS: Two parameters were demonstrated of decisive impact to increase in RBC-mass to preopeative autologous blood donation (PABD) (P<0.000): first, time interval between preoperative autologous blood donation and surgery, that correlated positively with efficacy; second, haematocrit-level at predeposit-session that correlated negatively with efficacy. The highest level of RBC-regeneration reached was observed four weeks after last blood donation (one unit:146.6+/-85.2 mL; two units: 297.4+/-78.6 mL). Patients with an anaemic initial haematocrit (females: <or=37%; males <or=40%) generated more RBC (*P<0.05) than non-anaemic patients (one unit: females, 148.3+/-67.6 vs 73.8+/-65.8 mL; males, 170.5+/-81.6 vs 77.0+/- 93.9 mL. Two units: females, 295.0+/-58.5 vs 226.0+/-79.7 mL; males, 299.9+/-82.5 vs 234.6+/- 107.5 mL). CONCLUSIONS: To improve efficacy of preoperative autologous blood donation, a time interval between (last) autologous predeposit and surgery of at least 4 weeks should remain for efficacious RBC-regeneration; together with an acute and strong decline in haematocrit due to the autologous predeposit to push erythropoiesis as efficaciously as possible.
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