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Clinical Experience with the Implementation of Accurate Measurement of Blood Loss during Cesarean Delivery: Influences on Hemorrhage Recognition and Allogeneic Transfusion
| Content Provider | Scilit |
|---|---|
| Author | Zamudio, Stacy Al-Khan, Abdulla Douglas, Claudia Sledge, Sharon Tully, Griffeth Thurer, Robert L. Rubenstein, Andrew F. |
| Copyright Year | 2017 |
| Description | Objective This article compares hemorrhage recognition and transfusion using accurate, contemporaneous blood loss measurement versus visual estimation during cesarean deliveries. Study Design A retrospective cohort study using visually estimated blood loss (traditional, n = 2,025) versus estimates using a mobile application that photographs sponges and canisters and calculates their hemoglobin content (device, n = 756). Results Blood loss > 1,000 mL was recognized in 1.9% of traditional visual estimation patients, while measured blood loss of > 1,000 mL occurred in 8.2% of device patients (p < 0.0001). In both groups, this was accompanied by a greater decrease in transfusion-adjusted hemoglobin levels than occurred in patients without hemorrhage (p < 0.0001). Despite similar transfusion rates (1.6% in both groups), fewer red cell units were given to transfused patients in the device group (1.83 ± 0.58 versus 2.56 ± 1.68 units; p = 0.038). None of the patients in the device group received plasma or cryoprecipitate. Seven patients in the traditional group received these products (p = 0.088). Device use was associated with shorter hospital stays (4.0 ± 2.3 versus 4.4 ± 2.9 days; p = 0.0006). Conclusion The device identified hemorrhages more frequently than visual estimation. Device-detected hemorrhages appeared clinically relevant. Blood product transfusion was reduced possibly due to earlier recognition and treatment, although further studies are needed to verify the conclusion. |
| Related Links | http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0037-1613675.pdf |
| Ending Page | 659 |
| Page Count | 5 |
| Starting Page | 655 |
| ISSN | 07351631 |
| e-ISSN | 10988785 |
| DOI | 10.1055/s-0037-1613675 |
| Journal | American Journal of Perinatology |
| Issue Number | 07 |
| Volume Number | 35 |
| Language | English |
| Publisher | Georg Thieme Verlag KG |
| Publisher Date | 2017-12-05 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Perinatology Public Health and Health Services Cesarean Delivery Blood Loss Postpartum Hemorrhage Quality Improvement |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
