Intraoperative Low-volume Acute Normovolemic Hemodilution in Adult Open-heart Surgery

Abstract

In patients undergoing elective open-heart surgery, low-volume ANH showed lack of efficacy in reducing the need for allogeneic transfusions and postoperative bleeding.

Acute Normovolemic Hemodilution in Cardiac Surgery

“…More recent studies have been published, with negative results. 65,66 However, in these studies, low-volume ANH was added to a well-defined blood conservation approach aiming at decreasing perioperative blood losses by the use of cell saving techniques and the administration of aprotinin or tranexamic acid. As a result, the hematocrit (or the hemoglobin concentration) before leaving the operating room was similar in the control and ANH patients.…”

Beneficial effect of acute normovolemic hemodilution in cardiovascular surgery

“…~3-~7 Hohn et at. conducted a prospective randomized study of 77 patients undergoing cardiac operations under moderate hypothermia, which showed 15 and they also found that low-volume ANH lacked efficacy. These were properly planned, randomized prospective trials, but the subjects underwent only relatively low invasive procedures, in terms of both surgical procedures performed and CPB conditions.…”

Acute normovolemic hemodilution in patients undergoing head and neck surgery: a prospective randomized trial

“…ANH is accomplished by drawing a unit of the patient's blood at the beginning of the surgery while administering 500 ml of colloid solution, and returning the autologous blood at the end of the surgery. This technique is used routinely in cardiac surgery and was tried in other major operations as part of blood conservation strategies with the purpose of reducing homologous blood transfusion [12][13][14]. We hypothesized that ANH could assist in lowering blood pressure during the surgery, thereby reducing the need for hypotensive drugs or other agents that decrease blood pressure.…”