The Use of Dextran 70 as a Plasma Expander Increases the Intraoperative Bleeding in Total Hip Replacement

Abstract

In total hip replacement (THR) dextran 70 is widely used as a plasma expander and as a thromboprophylactic agent. In a rec-hirudin multicenter dose-finding study approximately one third of the patients in our center received dextran 70 as a plasma expander at the beginning of the operation, the remainder received Haemaccel preoperatively. The average intraoperative bleeding was 1,572 ml (770-3,950 ml) in group 1 (dextran) and 1,160 ml (500-2,400 ml) in group 2. This difference is statistically significant (p = 0.002). The average postoperative bleeding was in group 1,273 ml (50-675 ml) and in group 2, 229 ml (0-870 ml), the difference is not significant. Total bleeding was in average 1,846 ml (850-4,250 ml) in group 1 and 1,451 ml (620-2,810 ml) in group 2; this difference is statistically significant (p = 0.012). Regarding the transfusion requirement measured in units; a median of 2, 5 units (0-8 units) were used in group 1 as opposed to 1.7 units (0-7 units) in group 2 (p = 0.055). The use of dextran 70 as a plasma expander led to significantly increased intraoperative bleeding. Key Words: Bleeding—Dextran—Hiparthroplasty.