Investigation of the effect of Acute Normovolemic Hemodilution and Tranexamic Acid on the amount of bleeding during off-pump coronary artery bypass graft surgery: a systematic review

Document Type : Review Article


Department of Anesthesia, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Postoperative bleeding and transfusion remain a source of morbidity and cost after open heart operations .
To evaluate the effect of ANH method and tranexamic acid on blood transfusion requirements and blood loss after off pump coronary artery bypass surgery (OPCAB).

Materials and Methods: The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE
from inception to December 2014; reference lists of published guidelines, reviews, and associated
articles, as well as conference proceedings.We included articles with available abstract in English language. Manual searching was done within the reference list of articles.

Three reviewers independently reviewed and assessed eligibility criteria, assessed quality, and extracted data.
Results: Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery that can reduced in combination of ANH method and tranexamic acid.
Conclusion: Tranexamic acid and ANH appear to be effective in reducing postoperative bleeding and the need for allogeneic blood products.