Acute normovolemic hemodilution: A state-of-art review

Allogeneic blood transfusion is a widely used traditional procedure but still represents a scarce and expensive resource in healthcare. It is also associated with complications such as transmission of infectious diseases, unfavorable outcomes and increased mortality rates. The COVID-19 pandemic worsened blood scarcity and revealed the need for alternatives such as patient blood management − a patient-centered approach that aims to improve clinical results by managing and preserving the patient’s own blood. Among the patient blood management techniques, acute normovolemic hemodilution stands out due to its benefits in surgeries with high potential for significant blood loss. Thepresent study is a systematized review of the literature that presents the state-of-artacute normovolemic hemodilution surveyed on MEDLINE, Cochraneand LILACS bases. The initial search found 14,775 articles, out of which 23 were included in the review. The articles were also analyzed using theQuADS (Quality Assessment with Diverse Studies) criteria.Patient blood management andacute normovolemic hemodilution are promising strategies to reduce allogeneic transfusions, thus improving clinical and economic outcomes. Implementation of multidisciplinarypatient blood management programs and standardization of the acute normovolemic hemodilution technique are essential to maximize their benefits. Tools such as the application developed by the authorsof the current review (hna.app.br)may favor the adoption of such techniques in the clinical practice for promoting efficient management of autologous blood and reducing perioperative complications.