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Quantification of surgical blood loss
Marcel H Lee1, Britt T Ingvertsen, Jolle Kirpensteijn
1Small Animal Veterinary Teaching Hospital, Department of Small Animal Clinical Sciences, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark. lee@dsr.kvl.dk
Objective:
To compare gravimetric and colorimetric methods of quantifying surgical blood loss, and to determine if there is a correlation between preoperative hemostatic tests (buccal mucosa bleeding time [BMBT] and intraoperative blood loss).
Study Design:
Prospective clinical study.
Animals:
Dogs (n=15) admitted for cutaneous tumor excision, orthopedic procedure, or exploratory laparotomy.
Methods:
Intraoperative blood loss was quantified by measuring irrigation fluid and weighing surgical sponges used for blood and fluid collection during surgery. Results of gravimetric measurements were then correlated to blood loss quantified using spectrophotometric analysis of hemoglobin (Hb) content. Hemostatic variables including BMBT were measured before surgery and compared with the calculated amount of blood loss.
Results:
Blood loss quantified by gravimetric measurement showed a significant correlation with colorimetric determination of Hb content in surgical sponges and collected irrigation fluid (r=0.93, P<.0001). BMBT correlated weakly but significantly with intraoperative blood loss (r=0.56, P<.05).
Conclusions:
Quantifying intraoperative blood loss using spectrophotometric Hb analysis accurately assessed the amount of blood loss; however, it is a time-consuming procedure, primarily applicable as a research tool. Gravimetric evaluation of intraoperative blood loss was found to be an accurate method, which can be recommended for use in a clinical setting.
Clinical Relevance:
Estimation of blood loss using a gravimetric method is accurate and applicable in the clinical setting and provides surgeons with a simple and objective tool to evaluate intraoperative blood loss.
