Effectiveness of Minimal Acute Normovolemic Hemodilution in Elective Adult Cardiac Surgery

Abstract

Background: The haematological care of cardiac surgery patients necessitates a careful equilibrium between excessive anticoagulation and the restoration of normal hemostasias following the operation. Objectives: The purpose of this study was to evaluate the impact of mild acute normovolemic hemodilution on blood transfusion needs and reopening in planned adult cardiac surgical intervention. Patients and methods: A prospective randomized observational research was carried out on one hundred patients that were planned to undergo planned adult cardiac surgery, aged from 40-65 years old. Participants were assigned randomly to 2 groups: acute normovolemic hemodilution group and controls. All participants were subjected to preoperative preparations and standard monitoring (pulse oximetry, lead II and V5 of the ECG). Results: haemoglobin, haematocrit had a significant increase in acute normovolemic hemodilution group than Controls in 2nd and 3rd (P<0.05). Platelet count showed significant increase in the study group than controls in 3rd (P = 0.042). Patient transfused with packed red blood cells, patient transfused with fresh frozen plasma, and chest tubed drainage were lower in study group than control group (P = 0.017, 0.028 and <0.001respectively). Conclusion: In this study, for patients undergoing elective coronary artery bypass graft surgery, minimal acute normovolemic hemodilution technique using 6% hydroxyethyl starch 130/0.4 (Voluven) reduces the need of allogenic blood transfusion, fresh frozen plasma transfusion, packed red blood cells and platelets. so, it decreases postoperative bleeding in patients underwent heart surgery. However, this technique had no effect on patients transfused with platelet concentrate.