Estimated blood loss

The second trial included 60 women who were randomized to oral misoprostol (400 micrograms) or intravenous oxytocin (10 IU) during cesarean section (12). Estimated blood loss was 545 ml (95% Cl = 476, 614) in those given misoprostol and 533 ml (95% Cl = 427, 639) in those given oxytocin. The hemoglobin concentration and hematocrit were similar in the two groups. 

A 53-year-old man, who had self-medicated with a saw palmetto supplement for benign prostatic hyperplasia, had profuse bleeding (estimated blood loss 2 liters) after resection of a meningioma and required 4 units of packed erythrocytes, 3 units of platelets, and 3 units of fresh frozen plasma (7). Postoperatively his bleeding time was 21 minutes (reference range 2-10 minutes), but all other coagulation tests were normal. He made an uneventful recovery. 

Committee for Proprietary Medicinal Products calreticulin deoxycoformycin dihydrofolate reductase estimated blood loss European Agency for the Evaluation of Medicinal Products... 

The estimate of actual intra-operative blood loss was compared to estimated blood loss (EBL) for 40 of the 45 planned procedures (one procedure was excluded because the surgery was not performed four procedures were missing a prediction of blood loss). Actual blood loss was less than the average EBL for the related proce-... 

Barton et al. (1996) reviewed their experience with 61 bone embolizations in 51 patients over a 10-year period. A total of 38 patients had metastatic renal cell carcinoma, six had thyroid carcinoma, four had breast cancer, one had uterine carcinoma, and two had metastatic adenocarcinoma from an unknown primary. In all, 32 cases were embolized preopera-tively for devascularization and 17 cases were embolized to debulk the tumor prior to radiation therapy or radioiodine therapy. In 11 patients, embolization was performed primarily to alleviate therapy resistant skeletal pain. One patient was embolized to control severe bleeding. The estimated blood loss during operative resection ranged between 500-1500 ml when performed within 3 days (27/32) of the embolization. Blood loss increased to between 1500-2800 ml... 

Obliteration of Tumor Blush / Estimated Blood Loss 193... 

Fig 15.3a-c. Left glenoid solitary RCC metastasis, s/p pre-operation embolization with PVA (350-500 pm), estimated blood loss of 75-100 ml. a Pre-embolization arteriogram showed the communication between two tumor feeders arrows), b S/p embolization of the major feeder, selective arteriogram shows partially occluded minor feeder with sluggish flow (arrow), c Completely embolized feeders with no tumor stain identified... 

Fig 15.4a,b. Obliteration of tumor stain by <50%, 700 ml of estimated blood loss, survival 6 months, a Pre-embolization arteriogram showing a hypervascular lesion in the right distal femur. The branches supplied a tumor arising directly from the popliteal artery many of them were too small for safe emholization (arrows), b Postembolization arteriogram with residual... 

Aprotinin. Aprotinin is a naturally occurring serine protease inhibitor, has found widespread applications either by the intravenous route or as a component of biological sealants, because of its ability to decrease blood loss, and, as a consequence, transfusion requirements. Anaphylactic reactions are mediated by IgG and IgE antibodies. The risk of anaphylactic reactions has been estimated between 0.5 and 5.8% when used intravenously during cardiac surgery, and at 5 for 100,000 applications when used as a biologic sealant [25]. Patients previously treated with this drug present an increased risk and any new administration should be avoided for at least 6 months following an initial exposure [25]. 

WARNING Anaphylactic Rxns w/ use use only if oral Fe not possible administer where resuscitation techniques available Uses Fe deficiency when cannot supl PO Action Fe supl Dose Adul. Iron defic anemia Estimate Fe deficiency, give 25-100 mg IM/IV /d until total dose total dose (mL) = [-.0442 x (desired Hgb - observed Hgb) x LBW] + (0.26 x LBW) Iron replacement, blood loss Total dose (mg) = blood loss (mL) x Hct (as decimal fraction) max 100 mg/d Peds >4 mo. As for adults max 0.5 mL (wt <5 kg), 1 mL (5-10 kg), 2 mL (>10 kg) p dose IM or direct IV Caution [C, M] Contra Anemia w/o Fe deficiency. Disp Inj SE Anaphylaxis, flushing, dizziness, inj site inf Rxns, metallic taste Interactions X Effects W/ chloramphenicol, X absorption of oral Fe EMS Anaphylactic Rxns common taking oral Fe t risk of tox and SEs OD May cause N/V, HA, muscle/joint pain and fev symptomatic and supportive Iron Sucrose (Venofer) [Iron Supplement] Uses Fe deficiency anemia w/ chronic HD in those receiving erythropoietin Actions Fe r lacement. Dose 5 mL (100 mg) IV on dialysis, 1 mL (20 mg)/min max Caution [C, M] Contra Anemia w/o Fe deficiency Disp Inj SE Anaphylaxis, -1- BP, cramps, N/V/D, HA Interactions i Absorption OF oral Fe supls EMS See Iron Dextran OD See Iron Dextran... 

Anaemia is the decrease in number of red blood cells or hemoglobin content caused by blood loss, deficient erythropoiesis, excessive hemolysis, or combination of these changes. Iron deficiency anaemia is probably the most common nutritional deficiency in the world. It is estimated that at least 500 million people are affected. Iron deficiency anaemia is much more common in developing countries, as people are consuming too little food or a limited variety of food. 

The child s estimated blood volume is 80 mL/kg, which is larger than an adult s on a milliliter per kilogram basis. Therefore, small amounts of blood loss can impair perfusion and decrease circulating blood volume. Children have greater cardiac reserves and catecholamine responses compared with adults, allowing them to compensate for fluid losses from hemorrhage, diarrhea, or lack of oral intake. However, shock and cardiopul-... 

Prevention of iron deficiency in populations not sustaining chronic blood loss is possible by judicious selection of diets which enhance the bioavailability of dietary iron. The recent decades have produced significant research on the availability of iron as it is affected by various dietary components, those which enhance as well as those which inhibit iron absorption. This has allowed for the first time the quantification of dietary effects on a trace metal and the development of a model whereby the quantity of bioavailable iron in a diet may be estimated. 

Values given for Hgb represent the amount of Hgb per volume of whole blood. The higher values seen in males are due to stimulation of RBC production by androgenic steroids, and to a lesser extent due to the decrease in Hgb in females caused by blood loss during menstruation. The level of Hgb can be used as a very rough estimate of the oxygen-carrying capacity of blood. Hgb levels may be diminished because of a decreased quantity of Hgb per RBC or because of a decrease in the actual number of RBCs. 

Table 3.5. Estimated fluid and blood losses based on hemorrhagic shock severity class on patient s initial presentation. From [42], with permission...

Several variables have been considered in measurement of the intended outcome, including intraoperative blood loss. Twelve studies evaluated intraoperative blood loss after renal artery embolization. In three studies, blood loss was based on subjective estimation only [48-50]. One study compared... 

It was realised after the Vietnam War that early life-support interventions after injury were critical to clinical outcome, and the American traumatologist R. Adams Cowley introduced the concept of the Golden Hour to emphasise this fact. Deaths following physical trauma come in three distinct waves. The first comprises persons who die within 30 min as a result of complex and overwhelming injury from which survival is impossible, such as major brain or vascular damage. The second wave, which comprises 30 % of the injuries, occurs after about 4 h and is the result of a combination of blood loss leading to shock and cellular damage and failure to maintain an adequate airway and ventilation. Airway obstraction, in particular, has been estimated to contribute to the death of 40 % of the victims. 

Working with rats, Lntz et al. (1977) compared the rates of loss from blood of 4,-CB (rapidly metabolized) with that of 2,2, 4,4, 5 -HCB (slowly metabolized). Both showed biphasic elimination, with the former disappearing much more rapidly than the latter. Estimations were made of the rates of hepatic metabolism in vitro, which were then incorporated into toxicokinetic models to predict rates of loss. The predictions for HCB were very close to actual rates of loss for the entire period of... 

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