The Effect of Acute Normovlumic Hemodilution in Reducing Allogenic Red Blood Cell Transfusion During and After Cardiac Surgery

Background: In this study effect of acute normovlumic hemodilution (ANH) to reduce consumption rate of allogenic blood transfusion was compared with the traditional protocol during and after cardiac surgery. Methods: One thousand patients who underwent elective cardiac surgery (CABG, valve surgery) were entered into study. In ANH group (n=500) blood obtained from patients by using a new formula and re-transfused the collected blood at the end of operation. Total amount of allogenic packed red blood cell (PRBC) and fresh frozen plasma (FFP) transfusion in ANH group was compared with 500 patients that had been operated one year ago in our hospital (Historical Control). Results: Considering the patients baseline hematocrit values ANH technique was used in 59% of patients in ANH group, and 12% in control group. In ANH group fewer patients during operation transfused with PRBC and FFP than control group (23.2% vs 71.4%; p = 0.001 and 31.2% vs 77.4%; p = 0.008, respectively). Significantly lower mean PRBCs units transfused in ANH group comparing with control group (1.1± 0.5 vs 2.4 ± 1.3 units; p = 0.006). After surgery PRBCs and FFP transfusion were lower in ANH group than control group. Mean postoperative bleeding was not significantly different in the two groups (884 ± 304 ml vs 790± 291 ml; p = 0.312). The incidence of postoperative complications, ICU stay and in-hospital mortality between the two groups were not significantly different (p 0.05). Conclusion: In this study, using the ANH significantly reduce consumption of allogeneic red blood cell and FFP in cardiac surgery patients.