[PREDICTING, POSSIBLE WAYS TO REDUCE AND CORRECTION OF MASSIVE INTRAOPERATIVE BLOOD LOSS IN SPINAL TUMOR SURGERY]

The paper discusses the problem ofpredicting, prevention and therapy of massive intraoperative blood loss in patients with metastasis in spine and spinal cord. We analyze 60 surgical cases in last 14 years in our clinic. Amount of blood loss was more that 80% of total blood volume in each case (from 2.5 to 17 liters). Preoperative selective angiography data on intensity of tumor blood supply were essential for blood loss prediction. Simultaneous embolization oftumor during angiography dramatically reduced intraoperative blood loss. Combination of blood saving techniques (preoperative autodonation, acute normovolemic hemodilution and intraoperative cell salvage) led to effective compensation of blood volume deficit and minimizing of allogenic blood transfusion. Plasma-derived and recombinant factors were effective in management of hemostatic disorders associated with massive blood loss.