Kanga cloths to smartphones: how should we measure blood loss in the operating room?

Excerpt

Accurate assessment and treatment of acute surgical blood loss has been an important focus of anesthesiologists for many decades. As reviewed by Bonica and Lyter in 1951, “The amount of blood lost during surgical operations is usually more than that estimated by the surgical team. Unless an adequate amount is replaced, shock may ensue, and the postoperative morbidity is prolonged”.1 In most adults, clinical signs of inadequate organ perfusion or shock present only when a significant amount of blood loss (> 750 mL) has already occurred,2 and these signs can be masked in patients under anesthesia. Early detection of hemorrhage (occult or obvious), and the volume replacement for such hemorrhage, is considered one of the primary responsibilities of the anesthesiologist. Another important aspect to consider is that the numerical value of estimated blood loss (EBL) as charted on the anesthetic or surgical record is used widely for outcome prediction and research purposes. Non-standardized or inaccurate measures of EBL therefore have the potential to cause bias in research and may in themselves result in adverse clinical outcomes due to unnecessary blood transfusion or lack thereof. …