Acute normovolemic hemodilution involves collecting one or more units of whole blood at the beginning of a surgical procedure and re-infusing it later at the end of the procedure. The blood volume removed for the whole blood collection is replaced with saline or other solution to retain blood volume, The concept is that the patient will bleed low hematocrit blood and will be reinfused with fresh high hematocrit blood containing all of the coagulation factors.
Intraoperative blood salvage and reinfusion is useful when large volumes of blood are lost. Examples are some liver transplant or cardiac procedures and trauma cases. It is useful when there is no malignancy and there is a sufficient amount of blood loss to make the set up of the equipment cost effective. Blood is aspirated from the surgical field, washed to remove vasoactive substances and then re-infused to the patient. Potential adverse events related to this process include air embolism and bacterial contamination.
