Cardiothoracic & vascular anaesthesia

A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery

N Engl J MedPublished Randomised controlled trial

Primary resultResult — go to the resultRelative risk 0.93 95% CI 0.81–1.07

Authors' conclusion

Among adults undergoing cardiac surgery, ANH did not reduce the number of patients receiving allogeneic red-cell transfusion.

Study context

Population
Adults undergoing cardiac surgery with cardiopulmonary bypass
Participants
2,010 adults
Comparison
ANH vs usual care
  • ANHn = 1,010
  • Usual caren = 1,000reference
Primary endpoint
Transfusion of ≥1 unit of allogeneic red cells
Follow-up
During the hospital stay
Methodological detailsmultinational, single-blind, 32 centres, 11 countries
  • Multinational
  • Single-blind
  • 32 centres, 11 countries

Primary result

As reported in the abstract

Relative risk

0.93

95% CI 0.81–1.07

P = 0.34

Events by treatment group

ANH vs Usual care
RR 0.93 (95% CI 0.81–1.07); P = 0.34

Secondary outcomes

Death within 30 days or during hospitalization

Safety

Surgery for postoperative bleeding

Surgery for postoperative bleeding

Safety outcomes similar in the two groups

Original publication

A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery. N Engl J Med. Published 12 June 2025. doi:10.1056/nejmoa2504948

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