{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:50:06Z","timestamp":1791993006651,"version":"4.4.0"},"reference-count":0,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[1996,11,1]],"date-time":"1996-11-01T00:00:00Z","timestamp":846806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1996,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute normovolemic hemodilution entails removal of blood from a patient either immediately before or shortly after induction of anesthesia and simultaneous replacement with cell\u2010free fluid. Nowadays, because of their predictable volume effects, the synthetic colloids (6% dextran 60\/70, 6% hydroxyethyl starch 200,000) are preferred as volume substitutes; albumin should be avoided because of its high cost. Hemodilution has experienced a renaissance in recent years, mainly due to the evolving discussion of legal aspects, immunologic changes, viral infections, and a potentially higher cancer recurrence rate associated with the transfusion of homologous blood. Hemodilution should be considered for elective surgical patients free of contraindications and presenting with an initial hemoglobin concentration \u2265 12\u00a0g\/dl and an anticipated blood loss of \u2265 1500\u00a0ml. The efficacy of this method (judged by the need to give homologous blood transfusion) depends on the preoperative (initial) hematocrit, the target hematocrit (to which hemodilution is performed), and the preset intra\u2010 and postoperative transfusion trigger. In the past, data from clinical trials showed that in healthy subjects a target hematocrit of 20% to 25% (hemoglobin 7.0\u20138.0\u00a0g\/dl) is feasible and safe for the patient. The lower the target hematocrit accepted, the more extensive is the monitoring required: Intraoperative target hemoglobin concentrations of 5.0\u00a0g\/dl and less have been tolerated by surgical patients without adverse effects. The safety and efficacy of acute normovolemic hemodilution in terms of reducing homologous blood transfusion requirements has been demonstrated in various clinical studies. Hemodilution therefore is regarded an integral part of programs aimed at reducing the need for homologous blood and can thus be successfully combined with preoperative autologous blood deposition, intraoperative blood salvage, and carefully adjusted surgical techniques. Hemodilution is feasible and relatively cost\u2010effective, and it minimizes adverse effects associated with transfusion of homologous blood, particularly transmission of viral diseases, immunosuppression, and infectious complications.<\/jats:p>","DOI":"10.1007\/s002689900184","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"1208-1217","source":"Crossref","is-referenced-by-count":76,"title":["Hemodilution in Clinical Surgery: State of the Art 1996"],"prefix":"10.1002","volume":"20","author":[{"given":"U.","family":"Kreimeier","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Ludwig\u2010Maximilians\u2010University Munich Klinikum Grosshadern Marchioninistrasse 15 D\u201081377 Munich Germany<!--<country1>DE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Messmer","sequence":"additional","affiliation":[{"name":"Institute for Surgical Research Ludwig\u2010Maximilians\u2010University Munich Klinikum Grosshadern Marchioninistrasse 15 D\u201081377 Munich Germany<!--<country1>DE<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1996,11]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002689900184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002689900184\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002689900184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T16:00:15Z","timestamp":1703692815000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002689900184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,11]]},"references-count":0,"journal-issue":{"issue":"9","published-print":{"date-parts":[[1996,11]]}},"alternative-id":["10.1007\/s002689900184"],"URL":"https:\/\/doi.org\/10.1007\/s002689900184","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,11]]}}}