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Overview :
Howe et al developed an equation for predicting the change in
hemoglobin associated with perioperative blood loss in orthopedic surgery. The
goal is to prevent unnecessary transfusion by helping surgeons gauge the degree
of blood loss. The authors are from the University of North Dakota in Grand
Forks, North Dakota.
Parameters:
(1) estimated blood loss in liters
(2) intravenous fluids administered in liters
(crystalloids)
where:
• It does
not appear that patients were transfused perioperatively. If blood is given, it
can be accounted for by assuming 1 unit will raise the hemoglobin 1 g/dL in the
adult.
change in hemoglobin in g/dL (preoperative minus
postoperative hemoglobin) =
= (1.001 * (estimated blood loss in liters)) + (0.441 *
(liters of intravenous fluids administered)) + 2.334
Performance:
• In adult
orthopedic surgery patients the estimated change in hemoglobin correlated with
the actual change observed.
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