Article 2025 · 2 atıf

Acute Normovolemic Hemodilution Versus Norepinephrine Infusion During Autologous Blood Donation in Coronary Artery Bypass Graft Surgery: A Prospective Randomized Study

Ozgodek, Habip Burak, Aydin, Muhammed Enes, Oksuz, Dilara Akcal, Karapinar, Yunus Emre, Ahiskalioglu, Elif Oral, Celik, Erkan Cem, Yayik, Ahmet Murat, Ahiskalioglu, Ali

Özet

Objective: This study was designed to compare the hemodynamic effects of acute normovolemic hemodilution (ANH) and norepinephrine infusion during autologous blood donation, with a particular focus on cardiac cycle efficiency (CCE), an energy-based parameter of cardiovascular performance. Design: A prospective, randomized clinical trial. Settings: Single-center, academic hospital. Participants: Forty patients undergoing coronary artery bypass graft surgery. Interventions: In the ANH group, a crystalloid solution was administered simultaneously to the contralateral upper extremity. The volume of replacement fluid was calculated at a 3:1 ratio relative to the volume of blood withdrawn. In the norepinephrine infusion (NA) group, no fluid was administered during the donation process. Instead, norepinephrine infusion was administered at a rate of 0.05 mg/kg/min. Measurements and Main Results: Hemodynamic parameters were monitored at three time points during the blood donation process. The primary outcome was the comparison of CCE changes between groups. Secondary outcomes included other advanced hemodynamic variables, metabolic indicators, and short-term postoperative clinical results. Changes in CCE during autologous blood donation were comparable between groups (ANH: 0.20 0.51, NA: 0.5 0.57, p = 0.373). Hemodynamic stability was achieved in both groups, with no relevant differences in cardiac index, stroke volume index, or metabolic markers (p > 0.05). Dynamic preload parameters showed expected physiological patterns in the norepinephrine group, consistent with volume-sparing circulatory support. None of the patients experienced acute kidney injury. There was no difference between the groups in terms of intensive care unit or hospital length of stay. Conclusions: Norepinephrine infusion demonstrated hemodynamic equivalence to ANH in the setting of autologous blood donation during coronary artery bypass graft surgery. Its ability to preserve circulatory function without fluid administration suggests it may serve as a viable alternative to ANH, particularly in patients requiring careful volume management. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Anahtar Kelimeler

autologous blood donation acute normovolemic hemodilution norephinephrine cardiac cycle efficiency CARDIAC CYCLE EFFICIENCY CONSERVATION POWER

WoS Kategorileri

Anesthesiology Cardiac & Cardiovascular Systems Respiratory System Peripheral Vascular Disease

Sürdürülebilir Kalkınma Amaçları

Sağlık ve Kaliteli Yaşam

Künye

Dergi: JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
Yıl: 2025
Cilt: 39
Sayı: 10
Sayfa: 2660-2669
ISSN: 1053-0770
eISSN: 1532-8422
DOI: 10.1053/j.jvca.2025.06.053
WoS UID: WOS:001578138900023

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