Acute Normovolemic Hemodilution Significantly Reduces RBC Transfusion and Lactic Acidosis Following Cardiac Surgery—A Propensity-Matched Study

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dc.contributor.authorSebt, Valaen_US
dc.contributor.authorSharifi, Shahnazen_US
dc.contributor.authorMeysamie, Alipashaen_US
dc.contributor.authorSaberi, Kianoushen_US
dc.date.accessioned2025-06-18T10:05:30Z
dc.date.available2025-06-18T10:05:30Z
dc.date.issued2025-06
dc.description.abstractBackground: Bleeding represents a major complication in heart surgeries. However, even small amounts of allogeneic blood are associated with reduced long?term survival and short?term complications. Acute normovolemic hemodilution (ANH) serves as a viable alternative, but its effectiveness and safety remain controversial. Objective: We aimed to clarify the effects of mild?volume ANH on blood transfusions and short?term complications following heart surgeries. Methods: This was a quasi?experimental study in a referral center on 2271 patients. We performed an extensive propensity?score matching to mitigate the lack of random assignment and potential selection bias. This resulted in 778 patients with no significant differences in 28 variables, including clinical, paraclinical, and operative features. Results: ANH significantly reduced the rate of RBC transfusion by 16% (50.9% vs. 60.9%; RR: 0.84; P = 0.006) and the number of transfused RBCs by 0.24 units (0.96 ± 1.32 vs. 1.20 ± 1.39; P = 0.013) but did not affect the transfusion of FFP or platelets. Furthermore, ANH significantly lowered the incidence of lactic acidosis by 53% (6.8 vs. 11.3%; RR: 0.47; P < 0.001) but had no notable impact on other short?term outcomes following heart surgery, including mortality, re?intubation, re?exploration, delayed sternal closure, length of ICU stay, or duration of mechanical ventilation. Conclusion: Mild?volume ANH significantly reduced the rate and amount of perioperative RBC transfusions, as well as the incidence of lactic acidosis following heart surgery. ANH did not affect the incidence of other complications during hospitalization. Implication: This suggests that ANH could be a safe and beneficial blood conservation technique. Further randomized clinical trials are needed to evaluate its effects.en_US
dc.identifier.affiliationsSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iranen_US
dc.identifier.affiliationsCritical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iranen_US
dc.identifier.affiliationsDepartment of Community and Preventive Medicine, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iranen_US
dc.identifier.affiliationsDepartment of Anesthesiology, Medical Faculty, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iranen_US
dc.identifier.citationSebt Vala, Sharifi Shahnaz, Meysamie Alipasha, Saberi Kianoush.Acute Normovolemic Hemodilution Significantly Reduces RBC Transfusion and Lactic Acidosis Following Cardiac Surgery—A Propensity-Matched Study.Annals of Cardiac Anaesthesia.2025 Jun;28(2):136-142en_US
dc.identifier.issn0971-9784
dc.identifier.issn0974-5181
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/247968
dc.languageenen_US
dc.publisherWolters Kluwer – Medknowen_US
dc.relation.issuenumber2en_US
dc.relation.volume28en_US
dc.source.urihttps://doi.org/10.4103/aca.aca_192_24en_US
dc.subjectCardiac surgeryen_US
dc.subjectlactic acidosisen_US
dc.subjectnormovolemic hemodilutionen_US
dc.subjectRBC transfusionen_US
dc.titleAcute Normovolemic Hemodilution Significantly Reduces RBC Transfusion and Lactic Acidosis Following Cardiac Surgery—A Propensity-Matched Studyen_US
dc.typeJournal Articleen_US
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