An interventional study of Acute Normovolemic Hemodilution in Acute Normovolemic Hemodilution, sponsored by Second Affiliated Hospital, Zhejiang University, School of Medicine. Not yet recruiting at 8 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-30.
Sponsored by Second Affiliated Hospital, Zhejiang University, School of Medicine · Not applicable, Interventional, and Treatment
Malignant bone tumors often lead to skeletal complications, known as skeletal related events (SRE). These complications mainly include pathological fractures, severe pain, and spinal cord compression. Typically, SRE reduces overall survival rates and is associated with loss of mobility and social functioning, decreased quality of life, and significantly increased healthcare costs. Surgical resection is an important means of treating malignant bone tumors. The main goal of surgical treatment is to maintain the patient's function and mobility by relieving pain, preventing impending fractures and/or nerve compression, or stabilizing pathological fractures. Surgery for malignant bone tumors often requires extensive exploration, osteotomy, and prosthetic reconstruction. The surgery involves significant trauma and excessive bleeding from the wound. Therefore, there is a significant risk of perioperative blood loss and transfusion during surgery for malignant bone tumors. However, blood transfusion also brings transfusion related risks to patients, increases the incidence of postoperative complications, and increases the healthcare burden on patients and society. Acute normovolemic hemodilution (ANH) may help reduce allogeneic red blood cell transfusion. However, There is a lack of high-quality evidence to support the use of ANH in bone cancer surgery.
Malignant bone tumors often lead to skeletal complications, known as skeletal related events (SRE). These complications mainly include pathological fractures, severe pain, and spinal cord compression. Typically, SRE reduces overall survival rates and is associated with loss of mobility and social functioning, decreased quality of life, and significantly increased healthcare costs. Surgical resection is an important means of treating malignant bone tumors. The main goal of surgical treatment is to maintain the patient's function and mobility by relieving pain, preventing impending fractures and/or nerve compression, or stabilizing pathological fractures. Surgery for bone cancer often requires extensive exploration, osteotomy, and prosthetic reconstruction. The surgery involves significant trauma and excessive bleeding from the wound. Therefore, there is a significant risk of perioperative blood loss and transfusion during surgery for malignant bone tumors. However, blood transfusion also brings transfusion related risks to patients, increases the incidence of postoperative complications, and increases the healthcare burden on patients and society. Therefore, it is particularly important to develop a perioperative blood management (PBM) plan for these patients. Acute normovolemic hemodilution (ANH) may help reduce allogeneic red blood cell transfusion. However, There is a lack of high-quality evidence to support the use of ANH in bone cancer surgery.
Exclusion Criteria:
Except for not undergoing ANH, other care managements are the same as the experimental group
Patients in the ANH group had whole blood withdrawn after induction of anesthesia. Meanwhile, patients receive colloid solution according to the volume of blood withdrawn.
Procedure: Acute Normovolemic Hemodilution
The whole blood is withdrawn after induction of anesthesia. Blood is withdrawn from a large-bore catheter and stored in blood bags. Meanwhile, patients receive colloid solution according to the volume of blood withdrawn.
Perioperative red blood cell transfusion rate
The number of patients receiving RBCs transfusion from the start of surgery to hospital discharge.
Time frame: hospital discharge, an average of 10 days
The rate of perioperative transfusion of allogeneic blood products
This includes blood products such as plasma and platelets, erythrocytes
Time frame: hospital discharge, an average of 10 days
Wound drainage volume
Accumulated amount of wound drainage after surgery
Time frame: hospital discharge, an average of 10 days
Unplanned re-operation
Unplanned re-operation due to bleeding, infection or other reasons
Time frame: hospital discharge, an average of 10 days
Perioperative hemoglobin concentration
hemoglobin concentration during hospitalization
Time frame: hospital discharge, an average of 10 days
The coagulation function tests during the perioperative period
This includes thromboelastography result
Time frame: hospital discharge, an average of 10 days
Complication
embolic events, pulmonary complications, infection, acute kidney injury, death. Diagnose according to radiologic examination, sign and symptom
Time frame: hospital discharge, an average of 10 days
This study is not yet recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
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Second Affiliated Hospital, Zhejiang University, School of Medicine