Inclusion Criteria:  ≥18 years of age. Undergoing a first-time cardiac surgical procedure (i.e. isolated CABG, isolated single cardiac valve surgery or a combination of both or isolated ascending aorta replacement) with the use of cardiopulmonary bypass (CPB) and median sternotomy.  Exclusion Criteria:  Left ventricle ejection fraction <25% Emergency surgery History of bleeding disorder Inherited thromboembolic or infective endocarditis (active) Previous cardiac surgery Severe renal impairment (serum creatinine >250 μmol/L) Hemoglobin <80 g/L Thrombocytopenia (<50,000 platelets per μL) Expected circulatory arrest Body weight ≤50 kg Allergy to mannitol Pregnancy or breast feeding