Overview
Participants will be scheduled for primary cytoreductive surgery as part of their standard care. Before surgery, participants will be assigned by chance to a study group. Depending on which group they are in, they will receive either acute normovolemic hemodilution/ANH during surgery or standard surgical management during surgery. The researchers think acute normovolemic hemodilution/ANH may decrease the need for allogenic blood transfusion/ABT in people having primary cytoreductive surgery.
Eligibility
Inclusion Criteria:
- Adults (≥18 years)
- BLOODS score ≥2 as calculated by surgeon
- High preoperative suspicion (or diagnosis) of advanced primary epithelial ovarian, fallopian tube, or primary peritoneal carcinoma (stage IIIC or IV), as determined by CT or MRI of the abdomen/pelvis
- Planned for exploratory laparotomy and primary or interval cytoreductive surgery
- Preoperative hemoglobin concentration ≥10 mg/dl within 45 days of surgery
- Patients scheduled for cytoreductive surgery, with or without other planned procedures o Note: Patients scheduled for diagnostic laparoscopy should not be included
Exclusion Criteria:
- A history of active coronary artery disease
- Patients with a history of coronary artery disease will be eligible if they have had a cardiac stress study showing no reversible ischemia and normal LV function within 45 days of surgery.
- A history of cerebrovascular disease
- A history of congestive heart failure
- A history of uncontrolled hypertension
- A history of restrictive or obstructive pulmonary disease
- A history of renal dysfunction (Cr >1.6 mg/dl)
- Abnormal coagulation parameters (INR >1.5 not on coumadin, or platelet count <100,000 mcL)
- Presence of active infection
- Evidence of hepatic metabolic disorder (bilirubin >2 mg/dl, ALT >75 U/L in the absence of biliary tract obstruction)
- Preoperative autologous blood donation within last 30 days or plan to donate autologous blood prior to surgery
- Refusal to accept allogenic or autologous blood transfusion