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A new nomogram facilitating adequate haemodilution.

H Zetterström, L Wiklund

    Acta Anaesthesiologica Scandinavica
    |May 1, 1986
    PubMed
    Summary
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    A new nomogram simplifies calculations for deliberate haemodilution, determining preoperative blood volume and transfusion needs. This tool helps achieve a target final haematocrit of 33% during surgery.

    Area of Science:

    • Anesthesiology
    • Surgical Hemostasis
    • Transfusion Medicine

    Background:

    • Deliberate haemodilution requires precise calculation of preoperative blood volume and transfusion volumes relative to blood loss.
    • Achieving a target final haematocrit (Hct) is crucial for managing intraoperative blood loss.

    Purpose of the Study:

    • To introduce a nomogram designed to simplify calculations for deliberate haemodilution.
    • To facilitate determination of normal blood volume and acceptable blood loss for a target final Hct of 33%.

    Main Methods:

    • A nomogram was constructed using preoperative Hct, height, weight, and sex as input variables.
    • The nomogram yields normal blood volume and acceptable pre-transfusion blood loss (BL) by drawing three straight lines.
    • The nomogram was applied in 100 surgical patients with preoperative Hct > 35% and blood loss > 50% of calculated BL.

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    Main Results:

    • The nomogram facilitated calculations, reducing time-consuming mathematical operations.
    • In 51 patients receiving transfusion, the mean Hct decreased from 41% preoperatively to 33% postoperatively.
    • Sixty-three patients achieved a final Hct of 30-35%, with lower values attributed to underestimation of blood loss.

    Conclusions:

    • The nomogram is an easy-to-use tool for managing deliberate haemodilution.
    • It effectively helps achieve a target postoperative Hct close to 33% in most surgical patients.
    • The nomogram simplifies blood management strategies during procedures involving significant blood loss.