Hemodilution in high‐risk cardiac surgery: Laboratory values, physiological parameters, and outcomes

Autor: Domagoj Mladinov, Luz A. Padilla, Benjamin Leahy, Joseph B. Norman, Jacob Enslin, Riley S. Camp, Kyle W. Eudailey, Kenichi Tanaka, James E. Davies
Rok vydání: 2022
Předmět:
Zdroj: Transfusion. 62:826-837
ISSN: 1537-2995
0041-1132
Popis: Acute normovolemic hemodilution (ANH) is a blood conservation strategy in cardiac surgery, predominantly used in coronary artery bypass graft (CABG) and/or valve procedures. Although higher complexity cardiac procedures may benefit from ANH, concerns for hemodynamic instability, and organ injury during hemodilution hinder its wider acceptance. Laboratory and physiological parameters during hemodilution in complex cardiac surgeries have not been described.This observational cohort (2019-2021) study included 169 patients who underwent thoracic aortic repair, multiple valve procedure, concomitant CABG with the aforementioned procedure, and/or redo sternotomies. Patients who received allogeneic blood were excluded. Statistical comparisons were performed between ANH (N = 66) and non-ANH controls (N = 103). ANH consisted of removal of blood at the beginning of surgery and its return after cardiopulmonary bypass.Intraoperatively, the ANH group received more albumin (p = .04) and vasopressor medications (p = .01), while urine output was no different between ANH and controls. Bilateral cerebral oximetry (rSOThis study suggests hemodilution to be a safe and comparable blood conservation technique, even without accounting for potential benefits of reduced allogenic blood administration. The study may contribute to better understanding and wider acceptance of ANH protocols in high-risk cardiac surgeries.
Databáze: OpenAIRE
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