Is postoperative blood loss, loss of blood? A pilot study in cardiac surgical patients

Fransen, E.J.; de Jong, D.S.; Hermens, W.T.; Maessen, J.G.
July 2001
Perfusion;Jul2001, Vol. 16 Issue 4, p301
Academic Journal
The effect of estimating the blood balance using changes in erythrocyte volumes (EVs) instead of the routinely used changes in haematocrit values was studied in 20 patients scheduled for cardiac surgery. We determined the mean haematocrit of the effluent from the postoperative thoracic drainage system at various time intervals. These data were used to more accurately calculate the blood balance. From 8 h after surgery onwards, the haematocrit in the thoracic effluent was less than 10%. Total loss of thoracic effluent until 24 h after removal of the aortic crossclamp (ACC) was 1735 ± 803 ml. Calculated blood loss until 24 h after ACC was only 58% of the total thoracic effluent. Plasma volumes in these patients increased from preoperative values of 2505 ± 499 ml at admission to the hospital to maximum levels of 4969 ± 1027 ml at 12 h after ACC (p < 0.05). Blood volume rose to 159% of the preoperative value at 12 h after ACC, whereas the EV remained relatively stable, decreasing to 95% of the preoperative value at 4 h after ACC and increasing to 107% of the baseline value at 24 h after ACC. In the meantime, patient haematocrit decreased to 78% of the reference value at the time of induction of anaesthesia at 4 h after ACC and then increased to 84% at 24 h after ACC. Thus, the use of patient haematocrit considerably overestimates blood loss. The EV appears to be a more appropiate variable than haematocrit in monitoring the blood balance in cardiac surgical patients. Future studies should reveal whether the EV is practicable in daily clinical practice.


Related Articles

  • Age of transfused blood is not associated with increased postoperative adverse outcome after cardiac surgery. McKenny, M.; Ryan, T.; Tate, H.; Graham, B.; Young, V. K.; Dowd, N. // BJA: The British Journal of Anaesthesia;May2011, Vol. 106 Issue 5, p643 

    Background This study investigated the hypothesis that storage age of transfused red blood cells (RBCs) is associated with adverse outcome after cardiac surgery, and examined association between volume of RBC transfusions and outcome after cardiac surgery. Methods Adult patients undergoing first...

  • TRACS: Differing blood transfusion strategies yield similar complication, death rates in cardiac surgery patients.  // Cardiology Today;Dec2010, Vol. 13 Issue 12, p32 

    The article deals with a study which revealed an increased risk of mortality related to red blood cell transfusion in patients undergoing cardiac surgery.

  • Storage duration important for red cell transfusion. Sacher, Ronald A. // Hem/Onc Today;4/25/2008, Vol. 9 Issue 7, p45 

    The article discusses the results of a study on the storage duration of red blood cells (RBC) and its effects on patients. Data from the study showed that the length of time that RBC are stored may affect patients' risk for complications and overall survival rates after cardiac surgery. A...

  • Computational analysis of blood volume curves and risks of intradialytic morbid events in hemodialysis. Beige, Joachim; Sone, Jeremiah; Sharma, Arya M.; Rudwaleit, Martin; Offermann, Gerd; Distler, Armin; Preuschof, Lothar // Kidney International;Oct2000, Vol. 58 Issue 4, p1805 

    Focuses on the computational analysis of blood volume curves and risk of intradialytic morbid events in hemodialysis. Characterization of intradialytic morbid events; Factors influencing ultrafiltration balance; Influence of blood volume reduction on the occurrence of hypotension.

  • Risk scores to facilitate preoperative prediction of transfusion and large volume blood transfusion associated with adult cardiac surgery. Goudie, R.; Sterne, J. A. C.; Verheyden, V.; Bhabra, M.; Ranucci, M.; Murphy, G. J. // BJA: The British Journal of Anaesthesia;May2015, Vol. 114 Issue 5, p757 

    Background. The aim of this study was to develop two novel risk prediction scores for transfusion and bleeding that would be used to inform treatment decisions, quality assurance, and clinical trial design in cardiac surgery. Methods. Clinical data prospectively collected from 26 UK cardiac...

  • Increased long-term mortality with plasma transfusion after coronary artery bypass surgery. Bjursten, Henrik; Dardashti, Alain; Ederoth, Per; Brondén, Björn; Algotsson, Lars // Intensive Care Medicine;Mar2013, Vol. 39 Issue 3, p437 

    Purpose: Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This...

  • Evaluation of blood components exposed to coated arterial filters in extracorporeal circuits. Hussaini, Bader E.; Treanor, Patrick R.; Healey, Nancy A.; Tilahun, Daniel; Srey, Rithy; Xiu-Gui Lu; Khuri, Shukri F.; Thatte, Hemant S. // Perfusion;Sep2009, Vol. 24 Issue 5, p317 

    Background: Biocompatible surfaces play an important role in the inflammatory response during cardiopulmonary bypass (CBP), with the arterial filter contributing a large surface area of the circuit. Different filter-coating materials designed to improve blood-filter biocompatibility are...

  • Effects of 5-Day Exercise Training in Elderly Subjects on Resting Left Ventricular Diastolic Function and VO[sub2]max. Petrella, Robert J.; Cunningham, Donald A.; Paterson, David H. // Canadian Journal of Applied Physiology;Feb97, Vol. 22 Issue 1, p37 

    Examines the effects of 5-day exercise training on resting ventricular diastolic function and maximal aerobic power in the elderly. Decreased in isovolumic relaxation time; Increased in plasma and blood volume; Decline in ventricular diastolic function.

  • Determinants of distance walked during the six-minute walk test in patients undergoing cardiac surgery at hospital discharge. Oliveira, Géssica Uruga; Carvalho, Vitor Oliveira; de Assis Cacau, Lucas Pereira; de Araújo Filho, Amaro Afrânio; de Cerqueira Neto, Manoel Luiz; da Silva Junior, Walderi Monteiro; Fontes Cerqueira, Telma Cristina; de Santana Filho, Valter Joviniano // Journal of Cardiothoracic Surgery;2014, Vol. 9 Issue 1, p1 

    Introduction The aim of this study was to identify the determinants of distance walked in six-minute walk test (6MWD) in patients undergoing cardiac surgery at hospital discharge. Methods The assessment was performed preoperatively and at discharge. Data from patient records were collected and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics