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Calculation of the Residual Blood Volume after Acute, Non-Ongoing Hemorrhage Using Serial Hematocrit Measurements and the Volume of Isotonic Fluid Infused: Theoretical Hypothesis Generating Study.

Oh WS, Chon SB - J. Korean Med. Sci. (2016)

Bottom Line: Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock.Vital signs, central venous or pulmonary artery pressures are inaccurate.In vivo validation and modification is needed before clinical application of this model.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea .

ABSTRACT
Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, non-ongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma. For acute, non-ongoing hemorrhage, red blood cell volume would not change. A certain portion of the isotonic fluid would increase plasma volume. Mathematically, we suggest that the residual blood volume after acute, non-ongoing hemorrhage might be calculated as 0·25N/[(Hct1/Hct2)-1], where Hct1 and Hct2 are the initial and subsequent hematocrits, respectively, and N is the volume of isotonic solution infused. In vivo validation and modification is needed before clinical application of this model.

No MeSH data available.


Related in: MedlinePlus

The change in red blood cell volume (RBCV), plasma volume (PV), blood volume (BV), and hematocrit (Hct) according to time after acute, non-ongoing hemorrhage.
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Figure 1: The change in red blood cell volume (RBCV), plasma volume (PV), blood volume (BV), and hematocrit (Hct) according to time after acute, non-ongoing hemorrhage.

Mentions: When patients with hemorrhagic shock present to the emergency department (Stage 1: the time of initial contact with medical personnel), the standard management consists of obtaining blood samples including the initial Hct, rapid infusion of 30 mL/kg of isotonic solutions (usually normal saline) before possible transfusion, and immediate hemostasis as soon as possible. Usually, clinicians check subsequent Hct values (Stage 2: the time to check subsequent Hct), while loading the isotonic solution. Using the designation of subscript of 1 and 2, we can define the BV, PV, and Hct at each time point as described in Fig. 1.


Calculation of the Residual Blood Volume after Acute, Non-Ongoing Hemorrhage Using Serial Hematocrit Measurements and the Volume of Isotonic Fluid Infused: Theoretical Hypothesis Generating Study.

Oh WS, Chon SB - J. Korean Med. Sci. (2016)

The change in red blood cell volume (RBCV), plasma volume (PV), blood volume (BV), and hematocrit (Hct) according to time after acute, non-ongoing hemorrhage.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835611&req=5

Figure 1: The change in red blood cell volume (RBCV), plasma volume (PV), blood volume (BV), and hematocrit (Hct) according to time after acute, non-ongoing hemorrhage.
Mentions: When patients with hemorrhagic shock present to the emergency department (Stage 1: the time of initial contact with medical personnel), the standard management consists of obtaining blood samples including the initial Hct, rapid infusion of 30 mL/kg of isotonic solutions (usually normal saline) before possible transfusion, and immediate hemostasis as soon as possible. Usually, clinicians check subsequent Hct values (Stage 2: the time to check subsequent Hct), while loading the isotonic solution. Using the designation of subscript of 1 and 2, we can define the BV, PV, and Hct at each time point as described in Fig. 1.

Bottom Line: Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock.Vital signs, central venous or pulmonary artery pressures are inaccurate.In vivo validation and modification is needed before clinical application of this model.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea .

ABSTRACT
Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, non-ongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma. For acute, non-ongoing hemorrhage, red blood cell volume would not change. A certain portion of the isotonic fluid would increase plasma volume. Mathematically, we suggest that the residual blood volume after acute, non-ongoing hemorrhage might be calculated as 0·25N/[(Hct1/Hct2)-1], where Hct1 and Hct2 are the initial and subsequent hematocrits, respectively, and N is the volume of isotonic solution infused. In vivo validation and modification is needed before clinical application of this model.

No MeSH data available.


Related in: MedlinePlus