Combination of blood-saving methods decreases homologous blood requirements in scoliosis surgery.

A study was conducted in patients undergoing surgery for idiopathic scoliosis, to determine whether combining blood-saving methods would decrease the need for homologous blood. Five groups were compared in a prospective, randomized fashion. In control patients (n = 13), blood loss was replaced by colloids. Preoperative haemodilution (PHD group) was used in ten patients. In the intraoperative autotransfusion (IAT) group (n = 11), washed red cells were returned to the patient. In the PHD+IAT group, both methods were combined (n = 13). In the fifth group, in addition, arterial hypotension was maintained with sodium nitroprusside (the PHD+IAT+HA group, n = 10). The haemoglobin value was kept above 79 g/l. Total blood loss did not differ between groups. The use of homologous blood in the PHD+IAT and PHD+IAT+HA groups was significantly less than in controls. It is concluded that blood-saving measures can be combined with an augmentative effect.