key: cord-327314-8vz9x8f1
authors: Ni, Yan; Xu, Zhi-Jie; Zhang, Zhen-Feng; Yang, Chun; Liu, Cun-Ming; Gui, Bo
title: Acute normovolemic hemodilution for major cancer surgeries during the COVID-19 pandemic: A beacon of hope
date: 2020-05-15
journal: J Clin Anesth
DOI: 10.1016/j.jclinane.2020.109871
sha: 
doc_id: 327314
cord_uid: 8vz9x8f1

nan

cancer surgeries to be performed safely and at the earliest in such a situation of insufficient allogenic blood supplies.

This retrospective study's protocol was approved by the Institutional Review Board of our hospital (#2020-SR-110). In our hospital, the surgical treatments of 22 cancer patients scheduled for major cancer surgeries were cancelled multiple times because of the shortage of allogenic blood supplies during February 2020. ANH was applied to these patients at the suggestion of anesthesiologists.

All patients examined successfully underwent the scheduled surgeries. The baseline demographics, comorbidities, and types of surgery were shown in Table 1 . The volumes of ANH blood drawn and intraoperative blood loss were 400-800 mL and 100-1300 mL, respectively. Only one patient received 2 units of erythrocytes intraoperatively. As shown in Because safety is a major focus of surgical and perioperative care, preoperatively acquired blood and blood products remain a routine safeguard for patients undergoing major cancer surgeries. Although the absolute risk/benefit ratio for ANH is controversial, it is crucial to protect cancer patients from experiencing acute blood loss-induced life-threatening situation.

In clinical settings, we should address how anatomical features relevant to the surgery, complexity of resections, and technical skills of surgeons might induce massive intraoperative bleeding. A failure to consider these factors, without the availability of substantial allogenic blood supplies, would endanger patients.

In conclusion, anesthesiologists and surgeons must work together to surpass and overcome this intractable period. One of the beneficial procedures is to use ANH for patients with cancer to permit major surgeries to be performed at the earliest without further delays. Intraoperative Hb, Hct, Lac, and iCa 2+ levels. E-G). Perioperative Hb, Hct, and Plt levels.

Values was presented as median and interquartile range, and analyzed with the Mann-Whitney test or Kruskal-Wallis H test as appropriate. ANH: acute normovolemic hemodilution, Hb: hemoglobin, Hct: hematocrit, iCa 2+ : ionized calcium, Lac: lactate, Plt: platelet, POD: Table 1 Baseline demographics, comorbidities, and types of surgery. Laparoscopic radical nephrectomy 2 (9.1%) Laparoscopic radical prostatectomy 2 (9.1%) Laparoscopic radical cystectomy 2 (9.1%) Intracranial tumor resection 1 (4.5%)

Thoracoscopic pulmonary resection 1 (4.5%) Figure 1 

COVID-19) pandemic. Geneva: World Health Organization

Coronavirus disease 2019: coronaviruses and blood safety

Perioperative care and collaboration between surgeons and anaesthetists -it's about time

Impact of acute normovolemic hemodilution on allogeneic blood transfusion during open abdominal cancer surgery: a propensity matched retrospective study

The efficacy of acute normovolemic hemodilution for preventing perioperative allogeneic blood transfusion in gynecological cancer patients