scholarly journals The Value of Body Surface Area Used in Postpartum Hemorrhage Define Postpartum Hemorrhage 

2021 ◽  
Author(s):  
Xianyan Lu ◽  
Tao Liu ◽  
Yan Zhou ◽  
Lili Qiu ◽  
Yimin Dai
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Blood Volume ◽  
Body Surface ◽  
Postpartum Hemorrhage ◽  
Total Blood Volume ◽  
Total Blood ◽  
Specificity And Sensitivity

Abstract Background: Blood loss as a percentage of total blood volume for redefining PPH may be more appropriate compared to the 500ml cutoff for every pregnant woman. This study is to investigate the value of body surface area in redefining PPH.Methods: In our prospective clinical observational study, we calculated the total blood volume using body surface area and measured blood loss at delivery using gravimetric and volumetric methods for all pregnant women included in our cohort (n=1715). For the five different body surface area groups, we determined different percentages of blood loss in total blood volume among 1201 participants. Furthermore, we compared the prediction values in blood transfusion based on the quantification of bleeding or proportion of blood loss in total blood volume at different quintiles among 514 severe PPH cases. Results: The median total blood volume and body surface area were 4639ml and 1.73 m2, respectively. The median total blood volume increased with increasing body surface area, and the different proportions of total blood volume increased accordingly. The median blood loss was 380ml and represented 8.28% of total blood volume. The median measured 24h blood loss across quintile 1 to 5 was 363ml, 360ml, 390ml, 380ml, 440ml, respectively. Using the definition with blood loss of 500 ml and 13% percentage of total blood volume, the incidence of PPH was 30% and 19%. However, the changes of the circulatory system secondary to obstetric hemorrhage was not significantly different at each quintile. Additionally, use of blood loss or the percentage of blood loss in total blood volume has high specificity and sensitivity as the indicators to predict blood transfusion.Conclusions: Our results suggest that blood loss exceeds 13% of total blood volume as a definition of postpartum hemorrhage. Blood loss above 30% of total blood volume may be recommended for blood transfusion.

Acute Isovolaemic Haemodilution: The Best Option for Autologous Blood Transfusion in Africa?

1995 ◽  
Vol 25 (4) ◽  
pp. 152-155 ◽  
Author(s):  
Zacharia A Berege ◽  
Bart Jacobs ◽  
Michael R Matasha ◽  
Frank Mpelumbe ◽  
Ernestini Kimaro
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Autologous Blood ◽  
Autologous Blood Transfusion ◽  
Total Blood Volume ◽  
East African ◽  
Homologous Blood ◽  
Total Blood ◽  
Induction Of Anaesthesia ◽  
Donated Blood

The purpose of this study was to identify the best method of autologous blood transfusion to be applied in an East African hospital. One hundred and nine consecutive patients for whom major blood loss was anticipated were enrolled. Seventeen patients donated 1 unit of blood 3 days preoperatively and 92 underwent acute isovolaemic haemodilution prior to induction of anaesthesia. For the haemodiluted patients a 2:1 ratio of sterile pryogen-free saline to collected blood was used. One of the 16 patients from whom 2 units were withdrawn by haemodilution experienced hypovolaemia which was rapidly restored by additional transfusion of colloid. Of the patients who donated blood preoperatively only 23.5% were autotransfused compared to 98.9% of the haemodiluted patients. Of the latter 23.9% (22) had an intraoperative blood loss exceeding 15% of their total blood volume and 7.6% (7) lost more than 25%. Only one received homologous blood in addition. For hospitals with limited blood bank facilities and regular cancellation of surgery, the use of acute isovolaemic haemodilution is recommended. A 3:1 ratio of saline to blood is now advised when 1 unit is withdrawn and a part replacement with crystalloid when 2 units are collected.

Adrenocorticotropin response to graded blood loss in the cat

1984 ◽  
Vol 247 (3) ◽  
pp. E398-E404
Author(s):  
D. A. Bereiter ◽  
A. M. Zaid ◽  
D. S. Gann
Keyword(s):  
Blood Loss ◽  
Blood Volume ◽  
Sampling Period ◽  
Plasma Norepinephrine ◽  
Total Blood Volume ◽  
Total Change ◽  
Volume Determination ◽  
Total Blood ◽  
Unit Body Weight ◽  
Total Glucose

To assess the early endocrine and physiological responses to rapid blood loss, adult cats anesthetized with chloralose-urethan sustained transient hemorrhage (H) of different magnitudes for a 3-min duration. The magnitude of H was expressed as a percentage of initial total blood volume after plasma volume determination by dye dilution or on a per unit body weight basis. Considerable variation in total blood volume was observed at all body weights (range, 44.5–80.2 mg/kg). Adrenocorticotropin (ACTH) in peripheral venous plasma was not significantly altered by 10% H but increased modestly after 20% H by 5 min (148 +/- 67 pg/ml) and rose promptly after 30% H by 2 min (541 +/- 155 pg/ml) with a peak at 5 min (579 +/- 171 pg/ml). Total change in ACTH during the 15-min sampling period was proportional to the magnitude of H (r = 0.730, P less than 0.001). Mean arterial pressure (MAP) decreased significantly to all magnitudes of H by 1 min with a graded recovery during the 3-min hypovolemic period that was well correlated (r = 0.602, P less than 0.005) with the percentage of blood volume removed. Mean plasma glucose concentration was not significantly changed by 10 or 20% H but increased after 30% H by 5 min (46.2 +/- 10.2 mg/dl). Total glucose change from prestimulus levels during the 15-min sampling period was correlated with the magnitude of H (r = 0.731, P less than 0.001). Plasma norepinephrine increased equally after 20 or 30% H or 10 ml/kg H but was not significantly elevated after 10% H.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Loss as a Function of Body Surface Area

2016 ◽  
Vol 128 (6) ◽  
pp. 1274-1280 ◽  
Author(s):  
Radha Burtch ◽  
Chantal Scott ◽  
Lindsay Zimmerman ◽  
Ashlesha Patel
Keyword(s):  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface

Blood Loss as a Function of Body Surface Area

2017 ◽  
Vol 129 (5) ◽  
pp. 943
Author(s):  
Serkan Bodur ◽  
Mehmet Ferdi Kinci ◽  
Ibrahim Alanbay ◽  
Kazim Emre Karasahin
Keyword(s):  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface

scholarly journals The Development of Hypercoagulability State, as Measured by Thrombelastography, Associated with Intraoperative Surgical Blood Loss

1996 ◽  
Vol 24 (1) ◽  
pp. 20-25 ◽  
Author(s):  
K. F. J. Ng ◽  
J. W. R. Lo
Keyword(s):  
Blood Loss ◽  
Blood Volume ◽  
Surgical Patients ◽  
Moderate Degree ◽  
Total Blood Volume ◽  
Total Blood ◽  
Surgical Blood Loss

Thrombelastographic evidence of hypercoagulability, including shortening of r-time (P< 0.01); shortening of k-time (P<0.01); and widening of trace angle (P<0.01) were observed in a group of 21 Chinese surgical patients when (a) the amount of blood loss was at an estimated 10% of total blood volume and (b) the amount of blood loss was at an estimated 15% of blood volume. The amount of blood loss was documented by haemoglobin measurements. No evidence of hypercoagulability was observed at around one hour into the operation in the absence of bleeding. We conclude that a mild to moderate degree of surgical blood loss with haemodilution is associated with the development of hypercoagulability as measured by thrombelastography. Further studies looking at the thrombebolic outcome in such groups of patients is warranted. It is also suggested that caution should be exercuised in the use of intraoperative isovolaemic haemoldilution until the phenomenon is further investigated.

591 Cost Savings in Operative Burn Care

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S137-S138
Author(s):  
Tracy L Williams ◽  
Meaghan Voycik ◽  
Jenny A Ziembicki
Keyword(s):  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Surgical Intervention ◽  
Cost Savings ◽  
The Body ◽  
Effective Measure ◽  
Burn Care ◽  
Burn Surgery

Abstract Introduction “Over the past 30 years, techniques of early excision and grafting along with enhancement of critical care have significantly improved survival following severe burn. Despite these advancements, large volume blood loss associated with surgical intervention continues to be a challenging aspect of burn surgery.” (Sterling, 2011) “Estimates of blood loss in adults during burn surgery range from 196 to 269 ml for each percent of the body surface area excised and grafted.” (Cartotto, 2000) A gold standard to achieve hemostasis does not exist. Therefore, institutions rely on their habit, practices, and FDA guidelines to formulate a standard of care. (Groenewold et al, 2011) In multiple comparison studies, “telfa pads soaked in epinephrine solution are a mainstay of hemostasis.” (Sterling, 2010) In 2018, an epinephrine shortage led to an increase cost to the operating room (OR) during the surgical treatment of burn wounds. This prompted the pharmacy and OR to collaborate on a more cost-effective measure without compromising patient care. Methods In November 2018, the epinephrine dosages were modified. Dosages were changed from Epinephrine 1;1000, 1mg/ml, 60mg/L for adults and 30mg/L for pediatrics to Epinephrine 1:1000, 1mg/ml, 30mg/L for adults and 15mg/L for pediatric patient’s. Parameters were set as to the amount of product that would be preordered from the pharmacy for each patient based on the total body surface area to be excised and or grafted: Should additional quantities be needed, an arrangement was made that the pharmacy would prepare and deliver the solution to the OR within 15 minutes of order to avoid delays in treatment. The time periods examined were: June 1, 2018 though November 7, 2018 and November 8, 2018 through June 20, 2019. Total burn patients requiring surgical intervention admitted during this time frame were 180 and 184 patients. June 2018-November 2018 represents previous practice. November 2018-June 2019 represents the implementation of changes in epinephrine dosage and establishing parameters for ordering. Results The overall Cost Savings In Operative Burn Care in relation to decreasing the dosage of Epinephrine from November 2018 to June 2019 was $100,952.25. Setting parameters provided better estimation of need and resulted in a 26% decrease in ordered product. Better estimation of product led to a 9.3% decrease in waste. Decreasing waste led to a savings of $28,463.61. Monthly cost to the OR for Epinephrine solution decreased to $9708.30 per month indicating a savings of $26,291.70 per month. Conclusions Operative costs decreased therefore leading to departmental savings. Applicability of Research to Practice Burn wound hemostasis was accomplished using reduced doses of Epinephrine solution. Nurses have a clearer picture on the amount of Epinephrine solution to order for each patient. The amount of product waste was reduced.

Blood Loss as a Function of Body Surface Area Redefining Parameters of Obstetric Blood Loss

2017 ◽  
Vol 37 (3) ◽  
pp. 141
Author(s):  
R. Burtch ◽  
C. Scott ◽  
L. Zimmerman ◽  
A. Patel
Keyword(s):  
Blood Loss ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface

Index for Normalization of Blood Volume

1982 ◽  
Vol 63 (s8) ◽  
pp. 375s-377s ◽  
Author(s):  
Nguyen PH. Chau ◽  
Robert C. Tarazi ◽  
Fetnat M. Fouad ◽  
Michel E. Safar ◽  
Willem H. Birkenhäger ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Blood Volume ◽  
Body Surface ◽  
Body Height ◽  
Cleveland Clinic ◽  
Normal Subjects ◽  
Volume Index ◽  
Hypertensive Patients ◽  
Weight One

1. A general method for the development of a blood volume index was devised to allow inter-individual comparisons. 2. An accurate and acceptable blood volume index had to fulfil certain criteria; it had to be (1) not correlated with body size, (2) highly correlated with blood volume, (3) either dimension-less or expressible in units of length or of surface area and (4) simple to calculate. 3. Available data, from the Broussais Hospital, Paris, the Zuiderziekenhuis, Rotterdam and the Cleveland Clinic, Cleveland, Ohio, included six groups of normal subjects, male essential hypertensive patients and female essential hypertensive patients. 4. Extensive calculations, based on the available data, indicated that the equation BVI = BV/(a√H.W) (BVI = blood volume index, BV = blood volume, H = body height, W = body weight and a = a constant depending on the chosen units) was the simplest index which satisfied the above requirements. 5. As the equation SA = 0.165 √(H.W) (SA = body surface area, in m2, H in m and W in kg) is almost identical with the Dubois & Dubois formula predicting body surface area from height and weight, one may choose a = 0165 and the index BVI = BV/[0.165 √(H.W)] (/H in m, W in kg, BV in ml and BVI in ml/m2). Thus blood volume is referred to body surface area. 6. Blood volume referred to unit body surface area appears, at the present, to be the most appropriate ‘blood volume index’. However, studies of data from larger groups and from more centres are needed to confirm this conclusion.

Volume of blood removed for analytical purposes during hospitalization of low-birthweight infants.

1981 ◽  
Vol 27 (5) ◽  
pp. 759-761 ◽  
Author(s):  
E Nexø ◽  
N C Christensen ◽  
H Olesen
Keyword(s):  
Body Weight ◽  
Blood Loss ◽  
Blood Volume ◽  
Low Birthweight ◽  
Blood Sampling ◽  
Total Blood Volume ◽  
Very Low Birthweight ◽  
Acid Base ◽  
Total Blood ◽  
Sodium And Potassium

Abstract Iatrogenic hazards may be induced by blood sampling in very-low-birthweight neonates. We report the number and types of analyses performed on 20 neonates with a birthweight below 1500 g during their first four weeks of hospitalization. Blood was sampled one to 13 times per infant per day on 382 of the 435 total days of hospitalization. The average blood loss was 7 to 51 mL per kilogram of body weight per four weeks--that is, from 5 to 45% of the calculated total blood volume. Of the blood removed, about 25% was in excess of the need for analytical procedures. Of the analyses, 40% were for acid-base, sodium, and potassium analyses--analyses for which transcutaneous methodology has been or is being developed. We conclude that because of the risks for low-birthweight neonates, procedures for blood sampling and analysis should periodically be reviewed, so as to minimize the number of samplings and the amount of blood removed.

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