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Defining Dogma: Quantifying Crystalloid Hemodilution in a Prospective Randomized Control Trial with Blood Donation as a Model for Hemorrhage  Samuel Wade.

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Presentation on theme: "Defining Dogma: Quantifying Crystalloid Hemodilution in a Prospective Randomized Control Trial with Blood Donation as a Model for Hemorrhage  Samuel Wade."— Presentation transcript:

1 Defining Dogma: Quantifying Crystalloid Hemodilution in a Prospective Randomized Control Trial with Blood Donation as a Model for Hemorrhage  Samuel Wade Ross, MD, MPH, A. Britton Christmas, MD, FACS, Peter E. Fischer, MD, MS, FACS, Haley Holway, MD, Rachel Seymour, PhD, Ciara R. Huntington, MD, B. Todd Heniford, MD, FACS, Ronald F. Sing, DO, FACS, FCCM  Journal of the American College of Surgeons  Volume 227, Issue 3, Pages (September 2018) DOI: /j.jamcollsurg Copyright © 2018 American College of Surgeons Terms and Conditions

2 Figure 1 CONSORT flow diagram for patient accrual in the study and subsequent inclusion/exclusion and reasons. Eventually, 154 patients underwent analysis according to the group to which they were randomized. IVF, intravenous fluid. (Reprinted from Ross and colleagues11 with permission from Wolters Kluwer Health, Inc.) Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2018 American College of Surgeons Terms and Conditions

3 Figure 2 Hemoglobin levels by resuscitation group over time. *Indicates p < for the global test and p < for pairwise testing between experimental and control groups. Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2018 American College of Surgeons Terms and Conditions

4 Figure 3 Hemodilution formula. Starting Hgb is the pre-donation hemoglobin in this study, or applied to surgical patients, is the preoperative hemoglobin, or applied to traumatic cases, could be estimated as the average hemoglobin for the person's age and sex. Blood loss coefficient, l = g/dL; EBL, estimated blood loss; equilibration coefficient, h = g/dL; resuscitation coefficient, r = g/dL; TBV, total blood volume; VR, volume replacement. Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2018 American College of Surgeons Terms and Conditions

5 Figure 4 Sample calculated immediate hemodilution hemoglobin value, for immediately after blood loss, after equilibration, and resuscitation (hemodilution). X is volume in liters (L) for estimated blood loss (EBL) or VR (volume replacement) on the x-axis. EBL (square) or volume of resuscitation (triangle), or both (diamond) lines. Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg ) Copyright © 2018 American College of Surgeons Terms and Conditions

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