Giving both enoxaparin and dextran increases the need for transfusion in revision hip arthroplasty.

OBJECTIVE

To find out if the need for transfusion was increased by volume substitution with dextran 70 in patients receiving prophylaxis against thrombosis with low molecular weight heparin.

DESIGN

Open randomised controlled trial.

SETTING

University hospital, Sweden.

SUBJECTS: 40 patients undergoing revision hip arthroplasty.

INTERVENTIONS: Enoxaparin 40 mg was given daily. Intraoperative normovolaemia was maintained with albumin (n = 20) or dextran 70 (n = 20). Intraoperative autotransfusion was used. Packed cell volume was kept above 0.29, if necessary with homologous blood.

MAIN OUTCOME MEASURES: External blood loss, red cell balance.

RESULTS

Dextran patients received 0.64 (0.2) g/kg of dextran (mean (SD)) and required more (p < 0.05) homologous blood (3.8 (2.4) units) than those receiving albumin (2.3 (1.6) units). The initial and final packed cell volumes were similar (0.40 and 0.32 compared with 0.41 and 0.32, respectively). The calculated loss of red cells was larger in the dextran group (1401 (511) compared with 1077 (374); p < 0.05).

CONCLUSION

The combination of enoxaparin and dextran appreciably increased the need for transfusion compared with enoxaparin alone.