Lorentz A, Gasteiger P, Osswald P M
Anaesthesist. 1987 Jun;36(6):306-12.
Introduction. The amount of blood loss during surgery that requires transfusion is frequently estimated with a linear formula (1) using blood volume--calculated on a volume per weight basis--, preoperative hemoglobin concentration, and an established minimum hemoglobin concentration. This formula, however, underestimates allowable pretransfusion blood loss, because it implies that all blood lost contains the initial hemoglobin concentration. In addition, hemodilution by infusion therapy prior to surgery is usually not taken into consideration. Methods. In order to estimate allowable pretransfusion blood loss more accurately and conveniently, a program was developed for a programmable pocket computer. This program calculates (number of equation in parenthesis): blood volume (2a, 2b) expansion of blood volume prior to surgery (3) hemodilution prior to surgery (4) allowable blood loss during isovolemic hemodilution (5). The applicability of the program to the situation during orthopedic operations was tested in a study in which allowable pretransfusion blood loss was estimated for one group of patients and was calculated with the computer program for another group of patients. Eighty patients undergoing major orthopedic surgery were studied. After preoperative evaluation the attending anesthetist established a minimum hemoglobin concentration and the type of cardiocirculatory monitoring to be used. Patients were divided at random into two groups: for one group blood volume was estimated on a volume per weight basis and allowable blood loss was calculated using equation (1); for the second group allowable blood loss was calculated with the computer program. During the evaluation of the data the computer calculations were also carrier out for group 1.(ABSTRACT TRUNCATED AT 250 WORDS)
引言。需要输血的手术中的失血量通常用线性公式(1)来估算,该公式使用基于体重计算的血容量、术前血红蛋白浓度以及既定的最低血红蛋白浓度。然而,这个公式低估了允许的输血前失血量,因为它意味着所有丢失的血液都含有初始血红蛋白浓度。此外,术前输液治疗引起的血液稀释通常未被考虑在内。方法。为了更准确、方便地估算允许的输血前失血量,为可编程袖珍计算机开发了一个程序。该程序可计算(括号内为公式编号):血容量(2a、2b)、术前血容量的扩充(3)、术前血液稀释(4)、等容血液稀释期间的允许失血量(5)。在一项研究中测试了该程序在骨科手术中的适用性,在该研究中,一组患者估算了允许的输血前失血量,另一组患者则用计算机程序进行计算。对80名接受大型骨科手术的患者进行了研究。术前评估后,主治麻醉师确定了最低血红蛋白浓度以及要使用的心脏循环监测类型。患者被随机分为两组:一组根据体重估算血容量,并使用公式(1)计算允许失血量;另一组用计算机程序计算允许失血量。在数据评估期间,也对第1组进行了计算机计算。(摘要截断于250字)