Department of Obstetrics and Gynecology, Hackensack Meridian Health, Hackensack, New Jersey.
Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack Meridian Health, Hackensack, New Jersey.
Am J Perinatol. 2021 Aug;38(10):1031-1035. doi: 10.1055/s-0040-1701507. Epub 2020 Feb 12.
The aim of the study is to compare quantified blood loss measurement (QBL) using an automated system (Triton QBL, Menlo Park, CA) with visual blood loss estimation (EBL) during vaginal delivery.
During 274 vaginal deliveries, both QBL and EBL were determined. The automated system batch weighs blood containing sponges, towels, pads, and other supplies and automatically subtracts their dry weights and also the measured amount of amniotic fluid. Each method was performed independently, and clinicians were blinded to the device's results.
Median QBL (339 mL [217-515]) was significantly greater than median EBL (300 mL [200-350]; < 0.0001). The Pearson's correlation between EBL and QBL was poor ( = 0.520) and the Bland-Altman's limits of agreement were wide (>900 mL). QBL measured blood loss >500 mL occurred in 73 (26.6%) patients compared with 14 (5.1%) patients using visual estimation ( < 0.0001). QBL ≥ 1,000 mL was recorded in 11 patients (4.0%), whereas only one patient had an EBL blood loss of 1,000 mL and none had EBL >1,000 mL ( = 0.002).
Automated QBL recognizes more patients with excessive blood loss than visual estimation. To realize the value of QBL, clinicians must accept the inadequacy of visual estimation and implement protocols based on QBL values. Further studies of clinical outcomes related to QBL are needed.
· QBL detects hemorrhage more frequently than visual estimation.. · Median QBL is significantly greater than median EBL.. · There is poor agreement between QBL and EBL..
本研究旨在比较阴道分娩时使用自动系统（Triton QBL，加利福尼亚州门洛帕克）进行量化失血量测量（QBL）与目测失血量估计（EBL）。
在 274 例阴道分娩中，同时进行 QBL 和 EBL 测定。自动系统批量称重含有海绵、毛巾、垫子和其他用品的血液，并自动减去其干重和测量的羊水量。每种方法均独立进行，临床医生对设备的结果不知情。
中位数 QBL（339mL[217-515]）明显大于中位数 EBL（300mL[200-350]；<0.0001）。EBL 和 QBL 之间的 Pearson 相关系数较差（=0.520），Bland-Altman 的协议界限较宽（>900mL）。使用目测估计，QBL 测量出血量>500mL 的患者有 73 例（26.6%），而出血量>500mL 的患者有 14 例（5.1%）（<0.0001）。记录到 11 例（4.0%）患者 QBL≥1000mL，而仅有 1 例患者 EBL 出血量为 1000mL，且无一例患者 EBL>1000mL（=0.002）。
与目测估计相比，自动 QBL 可识别更多出血量过多的患者。为了实现 QBL 的价值，临床医生必须接受目测估计的不足，并根据 QBL 值制定协议。还需要进一步研究与 QBL 相关的临床结局。
·QBL 比目测估计更频繁地检测出血。·QBL 的中位数明显大于 EBL 的中位数。·QBL 和 EBL 之间的一致性较差。
