Cardiothoracic & vascular anaesthesia
Acute Normovolemic Hemodilution in Adult Cardiac Surgery
Main findingResult — go to the resultOdds ratio 0.73 95% CI 0.60–0.89Authors' conclusion
In this study, a volume-dependent association was found between ANH and reduced RBC and non-RBC transfusion rates in patients undergoing cardiac surgery.
Study context
- Population
- Adults (≥18 years) undergoing coronary artery bypass grafting (CABG) and/or valve surgery with cardiopulmonary bypass (CPB), July 2020 to September 2023
- Participants
- 16,795 adults · 2,282 matched pairs
- Exposure
- Acute normovolemic hemodilution (ANH) vs no ANH
- ANHn = 2,282
- Controln = 2,282reference
- Outcome
- Intraoperative or postoperative transfusion of any blood component
Methodological detailspropensity-score matched, registry (Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database), ANH reported in 2463 cases (14.7%)
- Propensity-score matched
- Registry (STS Adult Cardiac Surgery Database)
- ANH reported in 2463 cases (14.7%)
Main finding
As reported in the abstract
Odds ratio
0.73
95% CI 0.60–0.89
P < 0.001
By group
ANH vs Control
OR 0.73 (95% CI 0.60–0.89); P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Mean difference (%) (95% CI) | P value | |
|---|---|---|---|
| Baseline hematocrit (before matching)ANH patients also had lower preoperative anemia rate | 2.5 (2.3–2.7) | P < 0.001 | |
| −2024Difference, % (linear scale) |
Red blood cells (RBC) and non-RBC transfusion, high-volume ANH (≥650 mL)
- Odds of transfusion further reduced by 47% to 64% for both RBC and non-RBC components
Cumulative transfused erythrocyte and platelet units
- Erythrocyte units lower in ANH vs control
- 167
- Platelet units lower in ANH vs control
- 295
- Lower acquisition and activity-based cost estimates with ANH
Original publication
Acute Normovolemic Hemodilution in Adult Cardiac Surgery. JAMA Surg. Published 1 November 2025. doi:10.
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