The impact of routine norepinephrine infusion on hemodilution and blood transfusion in cardiac surgery

Abstract

Background: Hemodilution and blood transfusion are associated with poor outcome after cardiac surgery. We hypothesized that routine norepinephrine infusion commenced prior to anesthesia induction during on-bypass cardiac surgery would reduce intraoperative hemodilution and red cell transfusion. Methods: Two cohorts of consecutive cardiac surgery patients at different time periods were retrospectively reviewed for perioperative hemoglobin, creatinine concentrations and units of red cells transfused. Patients in group NE (n=72, in 2010) all received standardized hemodynamic management by a single anesthesiologist with low dose norepinephrine infusion commenced at 3-5 μg.min-1 (18-30 nmol.min-1..