Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática

Objetivo: Describir la utilidad de la hemodilución normovolemica aguda como estrategia ahorradora de transfusión alogénica en pacientes mayores de 18 años llevados a cirugía no cardiaca. Materiales y Métodos: Se realizó una revisión sistemática (marzo 2025) siguiendo el protocolo PRISMA. Se buscó en...

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Autores:
Reyes Montenegro, Yeisson David
Rincón Suárez, Isabella
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2025
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
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oai:repositorio.unbosque.edu.co:20.500.12495/15594
Acceso en línea:
https://hdl.handle.net/20.500.12495/15594
Palabra clave:
Procedimiento quirúrgico hemodilución
Cirugía no cardíaca
Transfusión de sangre autóloga
Hemodilución normovolémica aguda
Transfusión de sangre alogénica
Surgical Procedure
Noncardiac Surgery
Hemodilution
Blood Transfusion, Autologous
Acute Normovolemic Hemodilution
Allogeneic Blood Transfusion
WO 200
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Attribution-NonCommercial-ShareAlike 4.0 International
id UNBOSQUE2_9a0df8c720f29d0a902f2a10d3996cd3
oai_identifier_str oai:repositorio.unbosque.edu.co:20.500.12495/15594
network_acronym_str UNBOSQUE2
network_name_str Repositorio U. El Bosque
repository_id_str
dc.title.none.fl_str_mv Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
dc.title.translated.none.fl_str_mv Acute normovolemic hemodilution as a blood optimization strategy in anesthesiology: a systematic review
title Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
spellingShingle Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
Procedimiento quirúrgico hemodilución
Cirugía no cardíaca
Transfusión de sangre autóloga
Hemodilución normovolémica aguda
Transfusión de sangre alogénica
Surgical Procedure
Noncardiac Surgery
Hemodilution
Blood Transfusion, Autologous
Acute Normovolemic Hemodilution
Allogeneic Blood Transfusion
WO 200
title_short Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
title_full Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
title_fullStr Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
title_full_unstemmed Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
title_sort Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemática
dc.creator.fl_str_mv Reyes Montenegro, Yeisson David
Rincón Suárez, Isabella
dc.contributor.advisor.none.fl_str_mv Galindo Gualdrón, Luz Adriana
dc.contributor.author.none.fl_str_mv Reyes Montenegro, Yeisson David
Rincón Suárez, Isabella
dc.contributor.orcid.none.fl_str_mv Reyes Montenegro, Yeisson David [0000-0002-4778-2877]
Rincón Suárez, Isabella [0009-0006-2907-1269]
dc.subject.none.fl_str_mv Procedimiento quirúrgico hemodilución
Cirugía no cardíaca
Transfusión de sangre autóloga
Hemodilución normovolémica aguda
Transfusión de sangre alogénica
topic Procedimiento quirúrgico hemodilución
Cirugía no cardíaca
Transfusión de sangre autóloga
Hemodilución normovolémica aguda
Transfusión de sangre alogénica
Surgical Procedure
Noncardiac Surgery
Hemodilution
Blood Transfusion, Autologous
Acute Normovolemic Hemodilution
Allogeneic Blood Transfusion
WO 200
dc.subject.keywords.none.fl_str_mv Surgical Procedure
Noncardiac Surgery
Hemodilution
Blood Transfusion, Autologous
Acute Normovolemic Hemodilution
Allogeneic Blood Transfusion
dc.subject.nlm.none.fl_str_mv WO 200
description Objetivo: Describir la utilidad de la hemodilución normovolemica aguda como estrategia ahorradora de transfusión alogénica en pacientes mayores de 18 años llevados a cirugía no cardiaca. Materiales y Métodos: Se realizó una revisión sistemática (marzo 2025) siguiendo el protocolo PRISMA. Se buscó en bases de datos (PUBMED, EMBASE, OVID MEDLINE, OVID EMB Reviews, LILACS en los últimos 10 años (2015-2025), textos completos, adultos, en los que apliquen HNA en cirugía no cardíaca. Dos investigadores evaluaron artículos independientemente, registrando hallazgos en una tabla de evidencia. Se evaluó reducción de transfusiones, complicaciones, costos y estancia hospitalaria. La calidad de la evidencia se evaluó con ROBIS, RoB 2, ROBINS-E, AMSTAR 2 y GRADE. Resultados: Se incluyeron cinco artículos (342 pacientes). En uno de los estudios encontrados, se demostró que la HNA redujo significativamente los requerimientos de transfusión alogénica (RR: 0.39, 95% CI 0.24 - 0.62, P < 0.001). No se encontró diferencia en la mortalidad. La HNA podría llegar a reducir costos, sin embargo, no es posible cuantificarlo. No hubo información sobre complicaciones relacionadas. Conclusión: Se concluyó que la HNA podría ser una alternativa eficaz para reducir las transfusiones alogénicas en cirugía no cardíaca, sin embargo, las limitaciones en la evaluación de costos, la heterogeneidad de los estudios y la falta de datos sobre complicaciones no permitieron obtener evidencia suficiente para recomendar su uso. Se requiere más estudios para emitir una recomendación. Palabras clave: Procedimiento quirúrgico, cirugía no cardíaca, hemodilución, transfusión de sangre autóloga, hemodilución normovolémica aguda, transfusión de sangre alogénica.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-07-30T19:52:39Z
dc.date.available.none.fl_str_mv 2025-07-30T19:52:39Z
dc.date.issued.none.fl_str_mv 2025-07
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
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dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12495/15594
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.unbosque.edu.co
url https://hdl.handle.net/20.500.12495/15594
identifier_str_mv instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv 1. Vanderlinde ES, Heal JM, Blumberg N. Autologous transfusion. BMJ [Internet]. 2002 Mar 30 [cited 2024 Aug 2];324(7340):772–5. Available from: https://pubmed.ncbi.nlm.nih.gov/11923162/
2. Zhou J. A review of the application of autologous blood transfusion. Braz J Med Biol Res [Internet]. 2016 [cited 2024 Aug 2];49(9). Available from: https://pubmed.ncbi.nlm.nih.gov/27533770/
3. Murray D. Acute normovolemic hemodilution. Eur Spine J [Internet]. 2004 Oct [cited 2024 Sep 18];13 Suppl 1(Suppl 1). Available from: https://pubmed.ncbi.nlm.nih.gov/15197632/
4. Goodnough LT. Rationale for blood conservation. Surg Infect (Larchmt) [Internet]. 2005 Jun [cited 2025 Feb 5];6 Suppl 1(s1):s3–8. Available from: https://pubmed.ncbi.nlm.nih.gov/19284355/
5. Shander A, Goodnough LT. Objectives and limitations of bloodless medical care. Curr Opin Hematol [Internet]. 2006 Nov [cited 2025 Feb 2];13(6):462–70. Available from: https://pubmed.ncbi.nlm.nih.gov/17053460/
6. Catling S. Blood conservation techniques in obstetrics: a UK perspective. Int J Obstet Anesth [Internet]. 2007 Jul [cited 2024 Sep 18];16(3):241–9. Available from: https://pubmed.ncbi.nlm.nih.gov/17509870/
7. Monk TG. Acute normovolemic hemodilution. Anesthesiol Clin North Am [Internet]. 2005 Jun [cited 2024 Sep 18];23(2):271–81. Available from: https://pubmed.ncbi.nlm.nih.gov/15922899/
8. Epstein NE. Bloodless spinal surgery: a review of the normovolemic hemodilution technique. Surg Neurol [Internet]. 2008 Dec [cited 2024 Sep 18];70(6):614–8. Available from: https://pubmed.ncbi.nlm.nih.gov/18423553/
9. Tanner EJ, Filippova OT, Gardner GJ, Long Roche KC, Sonoda Y, Zivanovic O, et al. A prospective trial of acute normovolemic hemodilution in patients undergoing primary cytoreductive surgery for advanced ovarian cancer. Gynecol Oncol [Internet]. 2018 Dec 1 [cited 2024 Sep 18];151(3):433–7. Available from: https://pubmed.ncbi.nlm.nih.gov/30336947/
10. Jamnicki M, Kocian R, Van Der Linden P, Zaugg M, Spahn DR. Acute Normovolemic Hemodilution: Physiology, Limitations, and Clinical Use. J Cardiothorac Vasc Anesth [Internet]. 2003 [cited 2024 Sep 18];17(6):747–54. Available from: https://pubmed.ncbi.nlm.nih.gov/14689419/
11. Jarnagin WR, Gonen M, Maithel SK, Fong Y, DAngelica MI, Dematteo RP, et al. A prospective randomized trial of acute normovolemic hemodilution compared to standard intraoperative management in patients undergoing major hepatic resection. Ann Surg [Internet]. 2008 Sep [cited 2024 Sep 18];248(3):360–8. Available from: https://pubmed.ncbi.nlm.nih.gov/18791356/
12. Kreimeier U, Messmer K. Perioperative hemodilution. Transfus Apher Sci [Internet]. 2002 [cited 2024 Sep 18];27(1):59–72. Available from: https://pubmed.ncbi.nlm.nih.gov/12201472/
13. Joubert KE. Acute normovolaemic haemodilution--is it a solution to reduce perioperative blood transfusions? J S Afr Vet Assoc [Internet]. 2007 [cited 2024 Sep 18];78(4):188–94. Available from: https://pubmed.ncbi.nlm.nih.gov/18507216/
14. Lu SY, Konig G, Yazer MH, Brooks JP, Chen YF, Jeong JH, et al. Stationary versus agitated storage of whole blood during acute normovolemic hemodilution. Anesth Analg [Internet]. 2014 Feb [cited 2024 Sep 18];118(2):264–8. Available from: https://pubmed.ncbi.nlm.nih.gov/24445627/
15. Fischer M, Matsuo K, Gonen M, Grant F, Dematteo RP, D’Angelica MI, et al. Relationship between intraoperative fluid administration and perioperative outcome after pancreaticoduodenectomy: results of a prospective randomized trial of acute normovolemic hemodilution compared with standard intraoperative management. Ann Surg [Internet]. 2010 Dec [cited 2024 Sep 18];252(6):952–8. Available from: https://pubmed.ncbi.nlm.nih.gov/21107104/
16. Guo J, Yuan X, Zhou X, Jin X. Pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery with two hemodilution methods. J Clin Anesth [Internet]. 2017 May 1 [cited 2024 Sep 18];38:75–80. Available from: https://pubmed.ncbi.nlm.nih.gov/28372687/
17. Matot I, Scheinin O, Jurim O, Eid A. Effectiveness of acute normovolemic hemodilution to minimize allogeneic blood transfusion in major liver resections. Anesthesiology [Internet]. 2002 Oct 1 [cited 2024 Sep 18];97(4):794–800. Available from: https://pubmed.ncbi.nlm.nih.gov/12357142/
18. de Souza MAB, Klamt JG, Garcia LV. Effects of acute normovolemic hemodilution on blood coagulation: comparison between tests of an in vivo and an in vitro model. Rev Bras Anestesiol [Internet]. 2010 Jul [cited 2024 Sep 18];60(4):363–75. Available from: https://pubmed.ncbi.nlm.nih.gov/20659608/
19. Ergin B, Guerci P, Uz Z, Westphal M, Ince Y, Hilty M, et al. Hemodilution causes glycocalyx shedding without affecting vascular endothelial barrier permeability in rats. J Clin Transl Res [Internet]. 2020 Jun 6 [cited 2024 Sep 18];5(5):243. Available from: /pmc/articles/PMC7453805/
20. Iwase Y, Kohjitani A, Tohya A, Sugiyama K. Preoperative autologous blood donation and acute normovolemic hemodilution affect intraoperative blood loss during sagittal split ramus osteotomy. Transfus Apher Sci [Internet]. 2012 Jun [cited 2024 Sep 18];46(3):245–51. Available from: https://pubmed.ncbi.nlm.nih.gov/22483627/
21. Midorikawa Y, Saito J, Kitayama M, Toyooka K, Hirota K. Intra-operative intravascular effect of the difference in colloid solutions during acute normovolemic hemodilution. JA Clin Rep [Internet]. 2021 Dec 1 [cited 2024 Sep 18];7(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34518959/
22. Ni Y, Xu ZJ, Zhang ZF, Yang C, Liu CM, Gui B. Acute normovolemic hemodilution for major cancer surgeries during the COVID-19 pandemic: A beacon of hope. J Clin Anesth [Internet]. 2020 Oct 1 [cited 2024 Sep 18];65. Available from: https://pubmed.ncbi.nlm.nih.gov/32419742/
23. Ni Y, Ding XH, Xu ZJ, Zhang ZF, Zhang Y, Gui B. Association of acute normovolemic hemodilution with decreased length of hospital stay in rhesus-negative patients undergoing major cancer surgeries: a retrospective study. Ann Palliat Med [Internet]. 2021 [cited 2024 Sep 18];10(2):1815–24. Available from: https://pubmed.ncbi.nlm.nih.gov/33440958/
24. Boerner T, Tanner E, Filippova O, Zhou QC, Iasonos A, Tew WP, et al. Survival Outcomes of Acute Normovolemic Hemodilution in Patients Undergoing Primary Debulking Surgery for Advanced Ovarian Cancer: A Memorial Sloan Kettering Cancer Center Team Ovary Study. Gynecol Oncol [Internet]. 2021 Jan 1 [cited 2024 Sep 18];160(1):51. Available from: /pmc/articles/PMC8378264/
25. Atwa Daif AA, El Mageed Hassan YMA, El-Galil Ghareeb NA, Othman MM, Mohamed SAM. Cerebral effect of acute normovolemic hemodilution during brain tumor resection. J Neurosurg Anesthesiol [Internet]. 2012 Jan [cited 2024 Sep 18];24(1):19–24. Available from: https://pubmed.ncbi.nlm.nih.gov/21904221/
26. Scott KJ, Shteamer JW, Szlam F, Sniecinski RM. Platelet function, but not thrombin generation, is impaired in acute normovolemic hemodilution (ANH) blood. J Clin Anesth [Internet]. 2019 Dec 1 [cited 2024 Sep 18];58:39–43. Available from: https://pubmed.ncbi.nlm.nih.gov/31075622/
27. Balci ST, Pirat A, Torgay A, Cinar O, Sevmis S, Arslan G. Effect of restrictive fluid management and acute normovolemic intraoperative hemodilution on transfusion requirements during living donor hepatectomy. Transplant Proc [Internet]. 2008 Jan [cited 2024 Sep 18];40(1):224–7. Available from: https://pubmed.ncbi.nlm.nih.gov/18261592/
28. Bansal N, Kaur G, Garg S, Gombar S. Acute normovolemic hemodilution in major orthopedic surgery. J Clin Orthop Trauma [Internet]. 2020 Oct 1 [cited 2024 Sep 18];11(Suppl 5):S844–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32999566/
29. Habib AS, Moul JW, Polascik TJ, Robertson CN, Roche AM, White WD, et al. Low central venous pressure versus acute normovolemic hemodilution versus conventional fluid management for reducing blood loss in radical retropubic prostatectomy: a randomized controlled trial. Curr Med Res Opin [Internet]. 2014 [cited 2024 Sep 18];30(5):937–43. Available from: https://pubmed.ncbi.nlm.nih.gov/24351100/
30. Oppitz PP, Stefani MA. Acute normovolemic hemodilution is safe in neurosurgery. World Neurosurg [Internet]. 2013 May [cited 2024 Sep 18];79(5–6):719–24. Available from: https://pubmed.ncbi.nlm.nih.gov/22381828/
31. Grant MC, Resar LMS, Frank SM. The Efficacy and Utility of Acute Normovolemic Hemodilution. Anesth Analg [Internet]. 2015 Dec 1 [cited 2024 Sep 18];121(6):1412–4. Available from: https://pubmed.ncbi.nlm.nih.gov/26579641/
32. Kim J, Hwang J, Huh J, Nahm SF, Lim C, Park S, et al. Acute normovolemic hemodilution can aggravate neurological injury after spinal cord ischemia in rats. Anesth Analg [Internet]. 2012 Jun [cited 2024 Dec 11];114(6):1285–91. Available from: https://pubmed.ncbi.nlm.nih.gov/22451597/
33. Zauder HL. Acute normovolemic hemodilution. J Clin Anesth [Internet]. 2000 [cited 2024 Sep 18];12(6):498. Available from: https://pubmed.ncbi.nlm.nih.gov/11203428/
34. Sam AM, Gupta D, Radhakrishnan A, Sethuraman M, Dash PK, Pitchai S, et al. Autologous versus allogeneic blood transfusion: A comparative study of the peri-operative outcomes in a tertiary care hospital in South India amidst the COVID-19 pandemic. Transfus Apher Sci [Internet]. 2023 Oct 1 [cited 2025 Apr 12];62(5). Available from: https://pubmed.ncbi.nlm.nih.gov/37357057/
35. Manara J, Sandhu H, Wee M, Odutola A, Wainwright T, Knowles C, et al. Prolonged operative time increases risk of blood loss and transfusion requirements in revision hip surgery. Eur J Orthop Surg Traumatol [Internet]. 2020 Oct 1 [cited 2025 Apr 12];30(7):1181–6. Available from: https://pubmed.ncbi.nlm.nih.gov/32367218/
36. Lee SH, Kim DG, Shin HS. How to approach orthognathic surgery in patients who refuse blood transfusion. Arch Plast Surg [Internet]. 2020 [cited 2025 Apr 12];47(5):404. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7520241/
37. Ye H, Wu H, Li B, Zuo P, Chen C. Application of cardiovascular interventions to decrease blood loss during hepatectomy: a systematic review and meta-analysis. BMC Anesthesiol [Internet]. 2023 Dec 1 [cited 2025 Apr 12];23(1). Available from: https://pubmed.ncbi.nlm.nih.gov/36949393/
38. Dowidar AERM, Ezz HAA, El Dorf AAEA, Kasem MM. Iron alone or iron and erythropoietin added to acute normovolemic hemodilution in myomectomy patients: A randomized controlled trial. Egypt J Anaesth. 2016 Jan 1;32(1):21–7.
39. Yang L, Wang HH, Wei FS, Ma LX. Evaluation of acute normovolemic hemodilution in patients undergoing intracranial meningioma resection: A quasi-experimental trial. Medicine [Internet]. 2017 Sep 1 [cited 2025 Apr 12];96(38):e8093. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5617717/
40. Kulkarni S, Parina R, Henderson R, Derek E, Selby T, Kwon Y, et al. Transfusion-free Strategies in Liver and Pancreatic Surgery: A Predictive Model of Blood Conservation for Transfusion Avoidance in Mainstream Populations. Ann Surg [Internet]. 2023 Mar 1 [cited 2025 Apr 12];277(3):469–74. Available from: https://pubmed.ncbi.nlm.nih.gov/36538643/
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spelling Galindo Gualdrón, Luz AdrianaReyes Montenegro, Yeisson DavidRincón Suárez, IsabellaReyes Montenegro, Yeisson David [0000-0002-4778-2877]Rincón Suárez, Isabella [0009-0006-2907-1269]2025-07-30T19:52:39Z2025-07-30T19:52:39Z2025-07https://hdl.handle.net/20.500.12495/15594instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coObjetivo: Describir la utilidad de la hemodilución normovolemica aguda como estrategia ahorradora de transfusión alogénica en pacientes mayores de 18 años llevados a cirugía no cardiaca. Materiales y Métodos: Se realizó una revisión sistemática (marzo 2025) siguiendo el protocolo PRISMA. Se buscó en bases de datos (PUBMED, EMBASE, OVID MEDLINE, OVID EMB Reviews, LILACS en los últimos 10 años (2015-2025), textos completos, adultos, en los que apliquen HNA en cirugía no cardíaca. Dos investigadores evaluaron artículos independientemente, registrando hallazgos en una tabla de evidencia. Se evaluó reducción de transfusiones, complicaciones, costos y estancia hospitalaria. La calidad de la evidencia se evaluó con ROBIS, RoB 2, ROBINS-E, AMSTAR 2 y GRADE. Resultados: Se incluyeron cinco artículos (342 pacientes). En uno de los estudios encontrados, se demostró que la HNA redujo significativamente los requerimientos de transfusión alogénica (RR: 0.39, 95% CI 0.24 - 0.62, P < 0.001). No se encontró diferencia en la mortalidad. La HNA podría llegar a reducir costos, sin embargo, no es posible cuantificarlo. No hubo información sobre complicaciones relacionadas. Conclusión: Se concluyó que la HNA podría ser una alternativa eficaz para reducir las transfusiones alogénicas en cirugía no cardíaca, sin embargo, las limitaciones en la evaluación de costos, la heterogeneidad de los estudios y la falta de datos sobre complicaciones no permitieron obtener evidencia suficiente para recomendar su uso. Se requiere más estudios para emitir una recomendación. Palabras clave: Procedimiento quirúrgico, cirugía no cardíaca, hemodilución, transfusión de sangre autóloga, hemodilución normovolémica aguda, transfusión de sangre alogénica.Especialista en AnestesiologíaEspecializaciónObjective: Describe the utility of acute normovolemic hemodilution (ANH) as a blood conservation strategy reducing allogeneic transfusion in patients over 18 years undergoing non-cardiac surgery. Materials and Methods: We did a systematic review (March 2025) following PRISMA guidelines. Databases searched included PUBMED, EMBASE, OVID MEDLINE(R), OVID EMB Reviews (Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews), and LILACS during the last 10 years (2015-2025), full text, adult humans in which they used ANH in non-cardiac surgery. Two investigators independently screened the articles, extracted data into an evidence table, and assessed transfusion reduction, complications, costs, and hospital length of stay. Evidence quality was evaluated using ROBIS, RoB 2, ROBINS-E, AMSTAR 2, and GRADE. Results: Five articles (total n=342 patients) were included. In one of the studies found, they concluded ANH significantly reduced allogeneic transfusion requirements (RR: 0.39, 95% CI 0.24 - 0.62, P < 0.001). No difference in mortality was found. ANH could reduce costs, non the less, it cannot be quantified with certainty. There was no data regarding complications related to ANH. Conclusion: ANH could be an effective alternative for reducing allogeneic transfusions in non-cardiac surgery, however, limitations in cost evaluation, study heterogeneity, and insufficient data on specific complications did not allow us to obtain sufficient evidence to recommend its rutinary use. Further research is needed to make a recommendation.application/pdfAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Procedimiento quirúrgico hemodiluciónCirugía no cardíacaTransfusión de sangre autólogaHemodilución normovolémica agudaTransfusión de sangre alogénicaSurgical ProcedureNoncardiac SurgeryHemodilutionBlood Transfusion, AutologousAcute Normovolemic HemodilutionAllogeneic Blood TransfusionWO 200Hemodilución normovolemica aguda como estrategia de optimización sanguínea en anestesiología: revisión sistemáticaAcute normovolemic hemodilution as a blood optimization strategy in anesthesiology: a systematic reviewEspecialización en AnestesiologíaUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. 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