Effects Of Mild Volume Hemodilution On Perioperative Clinical Outcome In Patients Undergoing Cardiac Surgery

Objective:To evaluate the effect of mild volume acute normovolemic hemodilution(ANH)on intraoperative transfusion and other complications with patients who after cardiac surgery with the cardiopulmonary bypass(CPB).Methods:The retrospective analysis included 2,058 patients those underwent cardiac surgery between the 2010 to 2015.This study population was divided into two groups:(with ANH group and without ANH group).Propensity score adjustment analysis was used.We reported the association between the use of mild volume ANH and perioperative outcomes.Preoperative data included age,weightheight,sex,preoperative medications,and medical record information.Intraoperative data included the length of operation time,cardiopulmonary bypass(CPB)use,surgical procedure performed,and length of time,and aortic cross-clamp length of time.The primary outcome was the intraoperative RBC transfuse rate.Secondary outcomes included postoperative pulmonary infection,stroke,mortality,atrial fibrillation,acute kidney injury,reoperation for postoperative bleeding,postoperative ventilation time,length of ICU and hospital stay.Results:A total of 1,289 patients were identified.ANH was performed in 358 patients,and the remaining 931 patients did not receive any ANH.Five hundred of the total patients(38.8%)received perioperative RBC transfusions,10%of patients received platelet,and 56.4%of patients received fresh frozen plasma transfusions.Mild volume ANH administration was significantly combined with decreased intraoperative RBC transfusion rate,the number of RBC units and the decreased postoperative pulmonary infection(p<0.05)during the cardiac surgery.There was no difference between intraoperative fresh frozen plasma(FFP)and the platelet concentrate transfusions,as well as the postoperative and the total perioperative allogeneic transfusions.Furthermore,there was no significant difference regarding postoperative outcomes including mortality,prolonged wound healing,stroke,atrial fibrillation,reoperation for postoperative bleeding and acute kidney injury.There was also no difference in postoperative ventilation time,length of ICU and hospital stay.Conclusion:Based on the 5-year experience of mild volume ANH in cardiac surgeries with CPB in our singal retrospective cohort,mild volume ANH was combined with decreased intraoperative RBC transfusion and postoperative pulmonary infection in e patients undergoing cardiac surgery.However,there was no significant difference in postoperative and total perioperative allogeneic transfusions.