Effectiveness of Moderate Acute Normovolemic Hemodilution Combined with Tranexamic Acid on the Reduction of Allogenic Blood Transfusion in Patients Undergoing Off-pump Coronary Artery Bypass

Abstract

Introduction: There are different approaches to reduce the amount of blood loss and allogenic transfusion in cardiac surgery. Regarding this, the present study aimed to evaluate the blood sparing effect of acute normovolemic hemidilution (ANH) combined with intrao-perative tranexamic acid in patients undergoing off-pump coronary artery bypass (OPCAB).Material and Methods: This study was conducted on 80 consecutive patients scheduled for elective OPCAB. The patients were randomly subjected to tranexamic acid treatment (TA group) or to tranexamic acid plus ANH (ANH group). All data, including demographic information, allogenic transfusions (based on a prior defined criteria), amount of postoperative bleeding, and major complications, were recorded.Results: According to the results, the two groups were comparable in terms of the demographic data and intraoperative variables. The mean values of postoperative bleeding were 483±125 and 580±201 mL in the TA and ANH groups, respectively, indicating no significant difference between them in this regard. Total transfused packed red blood cells (PRBC) used in the TA and ANH groups were 15 and 20 units, respectively, which revealed no significant difference between the two groups in this respect (P=0.23). Furthermore, 12 and 10 patients in the TA and ANH groups were transfused with PRBC, respectively. Moreover, the two groups showed no significant difference in terms of the postoperative hematological variables (P>0.05).Conclusion: As the findings of the present study indicated, ANH was not effective in reducing postoperative bleeding and the need for allogenic blood products in the patients undergoing OPCAB.

Keywords

• Acute Normovolemic Hemodilution
• Off-pump Coronary Artery Bypass
• Tranexamic Acid