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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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