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 Release 22.0, Sept. 2008
 
Chapter : ch5. Transfusion Medicine Section : Estimation of Blood Loss and Prediction of Blood Transfusion Needs
  Estimating Blood Loss in the Bleeding Severity Index

  Online Excel Reference
Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

Landsfeld et al used an equation for estimating blood loss in the Bleeding Severity Index.

 

amount of blood loss in units of blood =

= (number of units transfused) + (((hematocrit initial in percent) – (hematocrit after in percent)) / 3) – ((estimated surgical blood loss in mL) / 400)

 

where:

• The original equation had the hematocrit divided by 0.03, which would mean that the hematocrits would be as decimal fractions.

• Dividing the hematocrit by 3 (preferably 2.941) gives the hemoglobin in g/dL.

• As a rough rule of thumb, 1 unit of blood will raise the hemoglobin by 1 g/dL.

• The 400 factor is an estimate for the volume of 1 unit whole blood. 1 unit of whole blood may vary in volume from 405 – 495 ml (AABB Technical Manual).

 

Blood Loss in Units

Degree

>= 3 units

severe

2 to < 3 units

moderate

1 to < 2 units

mild

 

where:

• Categories for minimal and massive blood loss could probably also be defined.

• The hematocrit would be affected by hemoconcentration and hemodilution.

 

  References:

Landsfeld CS, Anderson PA, et al. The Bleeding Severity Index: Validation and comparison to other methods of classifying bleeding complications of medical therapy. J Clin Epidemiol. 1989; 42: 711-718.

 

 

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