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Acute normovolemic hemodilution reduced the frequency and amount of perioperative allogeneic blood transfusion in pediatric and adolescent scoliosis surgery: a retrospective observational study

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Abstract

Purpose

The aim of the present study is to investigate whether acute normovolemic hemodilution (ANH) can reduce the frequency and amount of perioperative allogeneic blood transfusion (ABT) (intraoperative ABT and postoperative ABT until discharge from the hospital) in pediatric and adolescent scoliosis surgery.

Methods

This single-center, retrospective, observational study included the perioperative data of 147 patients who were 18 years old or younger and underwent scoliosis surgery. Patients were divided into groups according to whether they received ANH: i.e., an ANH group and control group. Propensity-score-adjusted multivariable logistic regression analysis was performed to determine whether ANH can reduce the frequency of perioperative ABT.

Results

A total of 125 patients were analyzed, 95 and 30 in the ANH and control group, respectively. The intraoperative/postoperative ABT frequency was significantly lower in the ANH group than in the control group (17.9% vs. 36.7%, p = 0.044). The amount of ABT [median (IQR): 0 (0, 0) mL/kg vs. 0 (0, 16.3) mL/kg, p = 0.033] was also significantly lower in the ANH group than in the control group. Propensity-score-adjusted multivariable logistic regression analysis indicated that ANH use [odds ratio: 0.15; 95% confidence interval: 0.03, 0.77; p = 0.023)] was associated with a lower risk of ABT after adjusting for intraoperative blood loss and duration of surgery.

Conclusion

ANH use can reduce the frequency and amount of perioperative ABT in pediatric and adolescent scoliosis surgery.

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Authors and Affiliations

  1. Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan

    Satoshi Uchida, Hirotaka Kinoshita, Daiki Takekawa, Junichi Saito & Kazuyoshi Hirota

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  1. Satoshi Uchida
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  2. Hirotaka Kinoshita
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  3. Daiki Takekawa
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  4. Junichi Saito
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  5. Kazuyoshi Hirota
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Contributions

SU, HK, and DT collected the data. DT analyzed the data and drafted the manuscript. JS and KH made the critical revision. All authors read and approved the final manuscript for submission.

Corresponding author

Correspondence to Daiki Takekawa.

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Uchida, S., Kinoshita, H., Takekawa, D. et al. Acute normovolemic hemodilution reduced the frequency and amount of perioperative allogeneic blood transfusion in pediatric and adolescent scoliosis surgery: a retrospective observational study. J Anesth 36, 484–492 (2022). https://doi.org/10.1007/s00540-022-03078-z

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