| Ming Yang,Jinlong Liu. Safety and efficacy of acute normovolemic hemodilution during liver surgery: A meta-analysis. Oncol Transl Med, 2019, 5: 285-292. |
| Safety and efficacy of acute normovolemic hemodilution during liver surgery: A meta-analysis |
| Received:July 28, 2019 Revised:December 26, 2019 |
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| KeyWord:safety and efficacy; acute normovolemic hemodilution (ANH); liver surgery; meta-analysis |
| Author Name | Affiliation | E-mail | | Ming Yang | Department of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical College | 263805652@qq.com | | Jinlong Liu | Department of Hepatobiliary Surgery, Affiliated Hospital of Chengde Medical College | liujl800813@163.com |
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| Abstract: |
| Objective: The aim of this study was to evaluate the safety and efficacy of acute normovolemic
hemodilution (ANH) during liver surgery.
Methods: Structured searches of the PubMed, Chinese Biological Medicine Database, and Cochrane
Library electronic databases were performed, followed by a meta-analysis of outcomes, including
intraoperative blood transfusion(s), intraoperative bleeding, postoperative hematocrit (Hct) levels,
postoperative prothrombin time (PT), and number of patients who underwent transfusions during liver
surgery.
Results: In total, 14 eligible studies were included in the meta-analysis, which revealed that ANH for liver
resection was associated with a reduction in intraoperative blood transfusions [weighted mean difference
(WMD) ?1.99; 95% confidence interval (CI) ?2.82 to ?1.16; P < 0.00001]. The ANH group experienced
less intraoperative bleeding (WMD ?72.81; 95% CI ?136.12 to ?9.50; P < 0.00001) and exhibited a lower
postoperative Hct level (WMD ?3.38; 95% CI ?7.14 to ?0.67; P < 0.00001) than the control group. Moreover,
meta-analysis revealed that postoperative prothrombin time was not affected by ANH (WMD ?0.02; 95% CI
?0.18 to ?0.32; P = 0.65). Finally, the number of patients requiring allogeneic transfusion was significantly
smaller in the ANH group than in the control group (odds ratio 0.13; 95% CI 0.09 to 0.18; P = 0.24).
Conclusion: Results of the present meta-analysis indicated that ANH can reduce intraoperative bleeding
and the need for blood transfusions. In addition, ANH did not negatively affect the coagulation system after
surgery; therefore, ANH appears to be safe and effective during liver surgery. |
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