Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparative Evaluation of Visual Estimation and Accurate Measurement of the Amount of Blood Loss during Surgery

Document Type : Original Article (s)

Authors
Soudabeh Jalali-Motlagh 1
Fazlollah Mojahed 2
Reza Farahmand-Rad 1
Athareh Nazri-Panjaki 3
1 Assistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Resident, Department of Anesthesiology and Critical Care, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3 Student of Anesthesia, Student Research Committee, School of Allied Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
10.22122/jims.v36i507.9976
Abstract
Background: The greater the ability to accurately estimate the amount of blood loss during surgery, the greater the readiness to deal with possible risks during surgery. Therefore, in this study, we aimed to compare the visual estimation and accurate measurements of the amount of blood loss during surgery in order to make better management of the bleeding during surgery and make proper cares in proper time.Methods: 31 patients undergoing surgery who referred to Firoozgar hospital in Tehran, Iran, in 2017 were entered this clinical trial study using simple sampling method. All patients underwent posterior spinal fusion (PSF) surgery. Then, the amount of bleeding during the operation was calculated in two ways: visual estimation and also using a sensitive scale. Data were analyzed via SPSS software using descriptive statistics and Wilcoxon test.Findings: The mean age of the participants was 41.4 years old, and the mean weight was 65.2 kg. There was a significant difference between the amount of bleeding calculated as a visual bleeding amount and the bleeding calculated by sensitive scale at the first hour of operation (P < 0.0001), and also at the second hour of operation (P < 0.0001).Conclusion: The amount of blood on the gauzes calculated by visual estimation was significantly lower than the actual estimation. In order to reduce this error, it is recommended that, in assessing the amount of blood on gauzes, in addition to the amount of gauze to be impregnated with the blood, the amount of moisture (moisture) of the gauzes should also be taken into account.
Keywords
Anesthesia
Surgical hemorrhage
Indirect estimation technics
  1. Mannucci PM, Levi M. Prevention and treatment of major blood loss. N Engl J Med 2007; 356(22): 2301-11.
  2. Farzi F, Mirmansouri A, Haryalchi K, Biazar G, Fakor F, Atrkar Roshan Z, et al. Evaluation of "the visual scale estimation" diagnostic accuracy in determination of the blood loss volume during abdominal hysterectomy compared with hemoglobin and hematocrit alterations before and after surgery. Iran J Surg 2016; 24(1): 27-34. [In Persian].
  3. Martinelli I, Lensing AW, Middeldorp S, Levi M, Beyer-Westendorf J, van Bellen B, et al. Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use. Blood 2016; 127(11): 1417-25.
  4. Meiser A, Casagranda O, Skipka G, Laubenthal H. Quantification of blood loss. How precise is visual estimation and what does its accuracy depend on?. Anaesthesist 2001; 50(1): 13-20. [In German].
  5. Patton K, Funk DL, McErlean M, Bartfield JM. Accuracy of estimation of external blood loss by EMS personnel. J Trauma 2001; 50(5): 914-6.
  6. Stolp I, Smit M, Luxemburg S, van den Akker T, de Waard J, van Roosmalen J, et al. Ambulance Transfer in Case of Postpartum Hemorrhage after Birth in Primary Midwifery Care in The Netherlands: A Prospective Cohort Study. Birth 2015; 42(3): 227-34.
  7. Turnbull AC, Tindall VR, Robson G, Dawson IM, Cloake EP, Ashley JS. Report on confidential enquiries into maternal deaths in England and Wales 1979-1981. Rep Health Soc Subj (Lond) 1986; 29: 1-147.
  8. Kasper DL, Harrison TR, Fauci AS, Braunwald E, Longo D, Hauser SL, et al. Harrison's principles of internal medicine. New York, NY: McGraw-Hill; 2005.p. 598-9.
  9. Yu CN, Chow TK, Kwan AS, Wong SL, Fung SC. Intra-operative blood loss and operating time in orthognathic surgery using induced hypotensive general anaesthesia: prospective study. Hong Kong Med J 2000; 6(3): 307-11.
  10. Ha TN, van Renen RG, Ludbrook GL, Valentine R, Ou J, Wormald PJ. The relationship between hypotension, cerebral flow, and the surgical field during endoscopic sinus surgery. Laryngoscope 2014; 124(10): 2224-30.
  11. van Kampen EJ, Zijlstra WG. Spectrophotometry of Hemoglobin and Hemoglobin Derivatives. In: Latner AL, Schwartz MK, editors. Advances in Clinical Chemistry. 23th ed. Philadelphia, PA: Elsevier; 1983. p. 199-257.
  12. Combs CA, Murphy EL, Laros RK, Jr. Factors associated with hemorrhage in cesarean deliveries. Obstet Gynecol 1991; 77(1): 77-82.
  13. Miskry T, Magos A. Randomized, prospective, double-blind comparison of abdominal and vaginal hysterectomy in women without uterovaginal prolapse. Acta Obstet Gynecol Scand 2003; 82(4): 351-8.
  14. Glover P. Blood loss at delivery: how accurate is your estimation? Aust J Midwifery 2003; 16(2): 21-4.
  15. Eipe N, Ponniah M. Perioperative blood loss assessment- how accurate? Indian J Anaesth 2006; 50(1): 35-8.
  16. Santoso JT, Dinh TA, Omar S, Gei AF, Hannigan EV. Surgical blood loss in abdominal hysterectomy. Gynecol Oncol 2001; 82(2): 364-6.
  17. Akhlaghi F, Taghipour Bazargani V, Jamali J. Visual estimation of post partum hemorrhage and its treatment. Tehran Univ Med J 2012; 70(4): 257-63. [In Persian].
  18. Maslovitz S, Barkai G, Lessing JB, Ziv A, Many A. Improved accuracy of postpartum blood loss estimation as assessed by simulation. Acta Obstet Gynecol Scand 2008; 87(9): 929-34.
  19. Moscati R, Billittier AJ, Marshall B, Fincher M, Jehle D, Braen GR. Blood loss estimation by out-of-hospital emergency care providers. Prehosp Emerg Care 1999; 3(3): 239-42.
Journal of Isfahan Medical School
Volume 36, Issue 507 - Serial Number 507
November and December 2019
Pages 1479-1484

  • Receive Date 21 April 2018
  • Accept Date 06 April 2022