454: Implementation of quantitative blood loss does not improve prediction of hemoglobin drop in deliveries with average blood loss

Objective: Overall objective of the study was to see effects of active management of third stage of labour (AMSTL) with oxytocin. Specific objective of the study was to look for incidence of Post-Partum Haemorrhage (PPH), length of 3rd stage, incidence of retained placenta and average blood loss. Methodology: A hospital based prospective, descriptive, observational study was carried out from 1st July 2005 to 30th June 2006 at department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital (KMCTH). All patients undergoing vaginal delivery excluding twins, polyhydraminios and instrumental deliveries were included in the study. The active management of 3rd stage included administration of 10 units IU of oxytocin, early cord clamping, controlled cord traction and uterine massage. Blood loss was estimated by visual inspection and measured by jar pressed against perineum. Result: Total number of deliveries during the study period was 530. There were 13 cases of PPH. Incidence of PPH was 2.4%. There were six cases each of uterine atony and genital tract trauma. One case was of retained placenta requiring Manual Removal (MRP). Average third stage duration was less than 5 minutes. Average blood loss was 90 ml. In 2 cases the third stage lasted more than 30 mins. Conclusion: Active management of 3rd stage of labour reduces the incidence of PPH from uterine atony, reduces the duration as well as average blood loss during third stage.condition. Key words: Labor analgesia; epidural, combined spinal epidural; complications, dural puncture, postdural puncture headache (PDPH); prevention. doi:10.3126/njog.v1i2.1490 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 25 - 27 Nov-Dec 2006

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Retroperitoneoscopic nephrectomy for a nonfunctioning kidney

Vojnosanitetski pregled ◽

10.2298/vsp170215112s ◽

2019 ◽

Vol 76 (6) ◽

pp. 577-581

Author(s):

Vuk Sekulic ◽

Jovo Bogdanovic ◽

Ranko Herin ◽

Senjin Djozic ◽

Mladen Popov

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Hospital Stay ◽

Demographic Data ◽

Postoperative Mortality ◽

Ct Urography ◽

Average Hospital ◽

Average Blood Loss ◽

Duration Of Surgery ◽

Functioning Kidney

Background/Aim. The minimally invasive laparoscopic nephrectomy was first performed in 1991. The objective of this paper was to present the surgical technique of retroperitoneoscopic nephrectomy and to our experience with this procedure in removal of non-functioning kidneys. Methods. This retrospective study enrolled 55 patients who underwent retroperitoneoscopic nephrectomy at our institution during the period from January 2011 to November 2016. All patients had a unilateral non-functioning kidney confirmed by intravenous or computed tomography (CT)- urography and renal scintigram. Their medical records were analyzed for demographic data, duration of surgery, average blood loss, duration of hospital stay as well as time to return to normal life activities. Results. The mean age of patients was 43 years (range 23?78). Perioperative or early postoperative mortality was not recorded. Mean operative time was 82 minutes (range 45?210). The average blood loss was 90 mL (40?450). The average hospital stay was 4 days (3?7). Return to life activity was in average after 12 days (9?15). Conclusions. Retroperitoneoscopic nephrectomy for a non-functioning kidney is a feasible, safe, and effective minimally invasive method. The length of hospital stay and convalescence was shorter than after open nephrectomy.

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The Effect of Ellagic Acid on the Thrombin-Induced Hemorrhagic Syndrome in the Rat

Blood ◽

10.1182/blood.v28.2.253.253 ◽

1966 ◽

Vol 28 (2) ◽

pp. 253-257 ◽

Cited By ~ 7

Author(s):

E. E. CLIFFTON ◽

A. GIROLAMI ◽

D. AGOSTINO

Keyword(s):

Blood Loss ◽

Intravenous Administration ◽

Ellagic Acid ◽

Intraperitoneal Administration ◽

Average Blood Loss

Abstract The intraperitoneal administration of thrombin increased the bleeding due to the amputation of the tail in the rat (average blood loss 4.6 ml.). The intravenous administration of ellagic acid in thrombin-injected rats reduced the average blood loss to 0.6 ml. This value was slightly more than the average blood loss noted in animals given only ellagic acid (0.2 ml.). Both these figures were much less than the average blood loss observed in control animals (3.2 ml.).

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Active Management of Third Stage of Labor: A Comparison of Various Uterotonic

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1294 ◽

2014 ◽

Vol 6 (3) ◽

pp. 151-155 ◽

Cited By ~ 3

Author(s):

Ruchika Goel ◽

Jai Kishan Goel ◽

Vineeta Modi ◽

Anshika Kashyap ◽

Shashi Bala Arya ◽

...

Keyword(s):

Blood Pressure ◽

Blood Loss ◽

South Asian ◽

Active Management ◽

Obstetrics And Gynecology ◽

Women Patients ◽

Third Stage Of Labor ◽

Third Stage ◽

A Prospective Study ◽

Hemoglobin Drop

ABSTRACT Aims and objectives This study was aimed at comparing the various uterotonics in active management of third stage of labor and reducing blood loss. Materials and methods A prospective study was conducted in the Department of Obstetrics and Gynecology of SRMSIMS, Bareilly, in 100 women. Patients were randomized into four groups of 25 each and were given oxytocic within 1 minute of delivery of the baby. Oxytocics used were 10 IU intramuscular oxytocin, 0.2 mg intravenous methylergometrine, 125 μg intramuscular 15-methyl PGF2-alpha and 600 μg tablet misoprostol per rectally in groups A, B, C and D respectively. Results Duration of third stage of labor recorded was minimum with methergine with mean duration of 3.84 ± 0.99 minutes and was maximum with prostodin with mean duration of 5.04 ± 1.02 minutes. Amount of blood loss observed was minimum with methergine (mean 131 ± 72.037 ml) and maximum with Prostodin (mean 435 ± 147.578 ml). Hemoglobin drop was also seen maximally with prostodin with mean drop of 0.872 ± 0.458 gm% and minimally with methergine with mean drop of 0.236 ± 0.221 gm%. Change in the general condition of the patients in the form of tachycardia, fall in systolic and diastolic blood pressure was observed maximum with prostodin group whereas, in other groups, there was no significant change. Conclusion It is concluded from this study that methergine is the uterotonic of choice followed by oxytocin for active management of third stage of labor. How to cite this article Modi V, Goel JK, Kashyap A, Arya SB, Kar J, Goel R. Active Management of Third Stage of Labor: A Comparison of Various Uterotonic. J South Asian Feder Obst Gynae 2014;6(3):151-155.

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Operative time, blood loss, hemoglobin drop, blood transfusion, and hospital stay in orthognathic surgery

Oral and Maxillofacial Surgery ◽

10.1007/s10006-017-0626-1 ◽

2017 ◽

Vol 21 (2) ◽

pp. 259-266 ◽

Cited By ~ 6

Author(s):

Ra’ed Ghaleb Salma ◽

Fahad Mohammed Al-Shammari ◽

Bishi Abdullah Al-Garni ◽

Mohammed Abdullah Al-Qarzaee

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Hospital Stay ◽

Orthognathic Surgery ◽

Operative Time ◽

Hemoglobin Drop

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Comparison of combined intraarticular (IA) and intravenous (IV) administration of tranexamic acid with IA and IV alone in patients undergoing total knee arthroplasty without drainage catheter: a clinical trial study

10.21203/rs.3.rs-664332/v1 ◽

2021 ◽

Author(s):

Nima Bagheri ◽

Mohammad Amin Amini ◽

Arezu Pourahmad ◽

Farzad Vosughi ◽

Alireza Moharrami ◽

...

Keyword(s):

Clinical Trial ◽

Blood Loss ◽

The Other ◽

P Value ◽

Drainage Catheter ◽

Total Knee ◽

Matched Case ◽

The Mean ◽

Double Blinded ◽

Hemoglobin Drop

Abstract Purpose we aim to determine the most effective route for TXA administration (among IA, IV, combined IA/IV) for TKA surgeries using tourniquet without drainage catheters Methods We performed a double-blinded clinical trial on a total of 147 TKA candidates. The amount of blood loss and hemoglobin drop were evaluated in three matched case groups administered TXA during the TKA either via IV, IA or IV plus IA route. Drainage catheter was used for none of the cases. Results The combined group showed an average blood loss of 630 ± 252 ml which was significantly lower than the IV group (878 ± 268 ml, P-value < 0.01) and the IA group (774 ± 288 ml, P-value = 0.03). Besides, the mean hemoglobin and hematocrit drop was significantly lower in the combined group compared to the other two groups, 48 and 72 hours postoperatively (P value < 0.05). Conclusions The TXA administration via IV plus IA route had 28% and 19% reduction of blood loss in comparison with using the TXA via IV alone and IA alone methods respectively. Therefore, given the surgery is performed with tourniquet application, TXA usage via IV plus IA route may be a more effective way for reducing the perioperative blood loss in TKA cases in patients undergoing TKA without drain placement.

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Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery

10.21203/rs.2.17441/v1 ◽

2019 ◽

Author(s):

ZhiDong Wang ◽

ZhenHeng Wang ◽

Huilin Yang ◽

RuoFu Zhu ◽

GuangDong Chen ◽

...

Keyword(s):

Treatment Group ◽

Blood Loss ◽

Intravenous Infusion ◽

Acetabular Fracture ◽

Repeated Treatment ◽

Intraoperative Blood Loss ◽

Single Treatment ◽

Multiple Treatment ◽

Fracture Surgery ◽

Hemoglobin Drop

Abstract Backgroud:Literature have reported that topical use of TXA can reduce perioperative blood loss in acetabular fracture surgery.We aim to investigate the effect of intravenous administration of tranexamic acid (TXA) on perioperative blood loss during acetabular fracture surgery Methods:From January 2016 to October 2019, 85 patients undergoing surgical treatment with intravenous TXA administration for acetabular fractures at our department were retrospectively analyzed. The patients were divided into three groups according to dosage of TXA: Single treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery (n = 33), repeated treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 h (n = 26), and multiple treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 and 6 h (n = 26). Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, surgery-related transfusion rate, postoperative thrombosis rate, and operation time were compared among these three groups Results:Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, and drainage volume in the single treatment group, repeated treatment group, and multiple treatment group were 932.7.0 ± 181.8 ml, 624.2 ± 138.7 ml, 32.2 ± 5.3 g/l, and 100.1 ± 30.1ml; 843.4 ± 153.0 ml, 567.3 ± 144.1ml, 27.6±3.8 g/l, and 86.1± 42.2 ml; and 748.0 ± 145.2ml, 521.1 ± 98.1ml, 24.4 ± 4.4g/l, and 64.8 ± 29.0 ml, respectively; the values were significantly different between groups (P <0.05). The surgery-related blood transfusion rates in the single treatment, repeated treatment, and multiple treatment groups were 51.5% (17/33), 23.0% (6/26), 19.2% (5/26), respectively. There was no statistically significant difference in surgery-related blood transfusion rates between groups Conclusions:Intravenous administration of TXA in acetabular fracture surgery can reduce total blood loss, intraoperative blood loss, and postoperative hemoglobin drop without increasing the risk of venous thrombosis. Multiple administrations before surgery, and at 3 h and 6 h during surgery are more effective than single and repeated administration

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Combined Use of Intravenous and Topical Tranexamic Acid Efficiently Reduce Blood Loss in Patients Aged over 60 operated with 2-level lumbar fusion

10.21203/rs.2.22192/v2 ◽

2020 ◽

Author(s):

Jianjiang Li ◽

Long Wang ◽

Tao Bai ◽

Yanlu Liu ◽

Yifei Huang

Keyword(s):

Blood Loss ◽

Tranexamic Acid ◽

Lumbar Fusion ◽

Control Group ◽

Transfusion Rate ◽

Total Blood ◽

Fusion Surgery ◽

Combined Use ◽

Group A ◽

Hemoglobin Drop

Abstract Purpose: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid （TXA）in patients (aged over 60) scheduled for 2-level lumbar fusion surgery. Methods: 280 patients scheduled for 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local,15 mg/kg IV-TXA, 2 g TXA in local ,and 100 ml IV, respectively. The results of total blood loss (TBL) , maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded. Results: The TBL was 635.49 ± 143.60, 892.62 ± 166.85, 901.11 ± 186.25, and 1,225.11 ± 186.25 mL for the combined group, the IV group, the topical group, and the control group, respectively.(p = 0.015, p = 0.001 respectively).The average maximum hemoglobin drop in the four above groups was 2.18 ± 0.24, 2.80 ± 0.37, 2.40 ± 0.64 ，and 3.40 ± 1.32 g/dL, respectively. No PE event was reported during the follow-up. Although asymptomatic DVT events was reported by 1, 2, and 2 patients in the combined group, topical group, and control group, respectively, there is no intergroup difference. Conclusions: The combined use of TXA effectively reduced total blood loss and blood transfusion rate in patients aged over 60 scheduled for 2-level lumbar fusion, without increasing the incidence of DVT and PE formation.

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Volemic loss in rapid maxilla expansion surgically assisted

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v5i6.1700 ◽

2016 ◽

Vol 5 (6) ◽

Author(s):

Ellen Cristina Gaetti Jardim ◽

Leonardo Perez Faverani ◽

Roberta Okamoto ◽

Elerson Gaetti-Jardim Jr ◽

Elio Hitoshi Shinohara

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Blood Level ◽

Deformity Correction ◽

Procedure Time ◽

Surgical Time ◽

Asa Classification ◽

Average Blood Loss ◽

Dentofacial Deformity ◽

Crystalloid Solutions

Surgeries for dentofacial deformity correction are procedures which are executed with considerable frequency nowadays and, due to their complexity concerning complications inherent to technique, such as arteriovenous lesions or even surgery time, may cause severe hypovolemia. Necessity of replacement of blood level through infusion of crystalloid solutions, colloids or even blood transfusion is always mandatory. This way, it is proposed in this study to quantify blood loss, as well as evaluate necessity of blood transfusion in 19 patients who underwent maxilla expansion. It was evaluated average arterial pressures, surgery procedure time, gender, volemic loss and ASA classification. Average blood loss was 296,84mL, with minimal value of 50mL and maximum 1000mL. We can conclude that hypovolemia and blood transfusion request in such surgeries was of small number, however, professionals should always be aware of surgical time and development of discerning surgical technique.Descriptors: Surgery; Hypovolemia; Blood Transfusion.

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Comparison of conservative and radical surgery in the management of placenta previa percreta

Perinatal Journal ◽

10.2399/prn.21.0291008 ◽

2021 ◽

Vol 29 (1) ◽

pp. 46-53

Author(s):

Burak Sezgin ◽

Burcu Kasap ◽

Eda Adeviye Şahin ◽

Aysun Camuzcuoğlu ◽

Hakan Camuzcuoğlu

Keyword(s):

Blood Loss ◽

Radical Surgery ◽

Placenta Previa ◽

Transfusion Rate ◽

Intraoperative Blood Loss ◽

The Mean ◽

Placental Invasion ◽

Caesarean Hysterectomy ◽

Hemoglobin Drop ◽

Type Of Surgery

Objective We aimed to compare the uterine sparing (US) surgery and hysterectomy for placenta previa percreta (PPP) management. Methods Data from PPP patients with anterior invasion who underwent US surgery and caesarean hysterectomy were retrospectively analyzed. The clinical and surgical outcomes of patients with PPP were compared according to the type of surgery. Results The mean intraoperative blood loss was lower in US surgery group than in caesarean hysterectomy group (1227.78±204.80 ml vs 1442.22±125.68 ml; p=0.017). The hemoglobin drop was also significantly lower in the patients with US surgery (1.87±0.68 g/dl vs 2.88±1.04 g/dl; p=0.026). Moreover, the mean total transfusion rate was also significantly lower in the patients with US surgery (1.33±0.87 U vs 2.33±0.71 U; p=0.016). Conclusion Uterine sparing surgery reduces intraoperative blood loss and transfusion rate in PPP patients with anterior placental invasion compared to hysterectomy. The temporary blockage of bilateral uterine and uteroovarian arteries with Satinsky clamps may potentially contribute to the success of US surgery.

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