Comparison of Hemodynamic Changes of Autologous Blood Transfusion with Hemologous Transfusion in Patients Undergoing Elective Orthopedic Surgery under General Anesthesia

Preparation of safe and enough blood products which can solve the physiologic needs during surgery is a big and old problem. The anesthetist must have adequate knowledge about indications and complications of transfusion. The method used in this study was acute normovolemic hemodilution which is a recommended procedure in reference books. The goals of this study were to determine the effects, benefits and side effects of this method. Patients & In a randomized clinical trial(RCT), 60 patients were evaluated in two groups of 30. All of them were ASA 1, 2 and between 15-45 years old who were candidates for elective orthopedic surgery. The induction and maintenance routs of anesthesia and used solutions were similar in two groups and all patients were intubated with one person. Blood bags were achieved from arterial line. Heart rates, mean arterial pressure, SPO2, ETCO2 and cardiac output(non invasive with NICO) were measured and recorded before induction, 1 hour later, 2 hours later and at the end of the surgery. Volume of blood loss was calculated at the end of surgery. The number of used blood bags in two groups was recorded. Number of heart rates 2 hours later and at the end of operation was statistically significant and was higher in autologous group(P=0.001, 0.00). Mean arterial pressure 2 hrs later and at the end of the surgery was statistically significant and different in two groups and were higher in autologous group(P=0.02, 0.005). ETCO2 was significantly different 1, 2 hrs later and at the end of the surgery and was lower in autologous group(P=0.005, 0.004, 0.00). Blood loss volume was statistically different in two groups and was lower in autologous group(P=0.00). Cardiac output was not statistically different in two groups. These results show that increase in heart rates after blood donation is probably due to induced stress in autologous group, but no change in cardiac output occurred. Also, mean arterial pressure and ETCO2 were different in two groups and were more satisfactory in autologous group. Furthermore, volume of blood loss was significantly lower in autologous group than hemologous group. It seems that autologous blood transfusion is a better method with more adequate hemodynamic control than hemologous transfusion.