Methods: We retrospectively evaluated data of a total of 101 adult patients (68 males, 33 females; mean age 61±8 years; range 46 to 84 years) who underwent elective coronary artery bypass grafting surgery between January 2014 and December 2015. A comparison was made between patients who received acute normovolemic hemodilution (ANH group, n=49) and patients who did not (control group, n=52) matched by predictors of mortality and postoperative bleeding.

Results: The mean decline in fibrinogen in ANH group (27.4±13.8%) was significantly lower, compared to the control group (43.7±9.5%, 95% CI: -21.4 to -11.3, p<0.0001). The mean decline in platelet count in ANH group (33.1±10.1) was similar to control group (35.6±8.9) (p=0.21). The whole blood was not re-transfused to 10 patients (20.4%) in ANH group at the end of surgery and preserved to be used in the intensive care unit. During intensive care unit stay, only eight patients (16.3%) in ANH group received allogeneic red blood cell, while 41 patients (78.8%) in the control group (p<0.0001). Only 14 patients (28.6%) in ANH group received allogeneic fresh frozen plasma, while all patients in the control group received (p<0.0001). No mortality was seen in either group.

Conclusion: Acute normovolemic hemodilution may preserve plasma levels of fibrinogen and reduce the need for allogeneic transfusion of blood products in patients with adequate preoperative fibrinogen level.