Andrew F Rubenstein1, Michael Block2, Stacy Zamudio3, Claudia Douglas4, Sharon Sledge5, Griffeth Tully6, Robert L Thurer6. 1. Department of Obstetrics and Gynecology, Hackensack Meridian Health, Hackensack, New Jersey. 2. Department of Anesthesia, Hackensack Meridian Health, Hackensack, New Jersey. 3. Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack Meridian Health, Hackensack, New Jersey. 4. Department of Nursing, Institute for Evidence-Based Practice and Nursing Research, Hackensack University Medical Center, Hackensack Meridian Health, Hackensack, New Jersey. 5. Department of Patient Safety and Quality, Center for Bloodless Medicine and Surgery, Hackensack Meridian Health, Hackensack, New Jersey. 6. Medical Department, Gauss Surgical, Inc., Los Altos, California.
Abstract
OBJECTIVE: To determine if accurate blood loss determination during cesarean delivery can improve the prediction of postoperative hemoglobin levels. STUDY DESIGN: This is 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: The correlation between the actual and predicted postoperative day 1 hemoglobin value (PPO1 Hgb) was better in the device group (R 2 = 0.519, correlation = 0.720) than in the traditional group (R 2 = 0.429, correlation = 0.655) (p = 0.005). For patients in the device group where the estimated blood loss was >1,000 mL (n = 53), the PPO1 Hgb was also better correlated with the actual value (R 2 = 0.319, correlation = 0.565) than the predictions using visually estimated blood loss for those patients in the device group whose visual estimation was >1,000 mL (n = 32) (R 2 = 0.035, correlation = 0.187) (p = 0.027). CONCLUSION: Implementation of a device that accurately measures blood loss allows for a better prediction of postoperative day 1 hemoglobin concentration than is possible using visual blood loss estimation. This improvement was seen in the entire patient group and was particularly prominent in patients with blood losses of > 1,000 mL. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To determine if accurate blood loss determination during cesarean delivery can improve the prediction of postoperative hemoglobin levels. STUDY DESIGN: This is 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: The correlation between the actual and predicted postoperative day 1 hemoglobin value (PPO1 Hgb) was better in the device group (R 2 = 0.519, correlation = 0.720) than in the traditional group (R 2 = 0.429, correlation = 0.655) (p = 0.005). For patients in the device group where the estimated blood loss was >1,000 mL (n = 53), the PPO1 Hgb was also better correlated with the actual value (R 2 = 0.319, correlation = 0.565) than the predictions using visually estimated blood loss for those patients in the device group whose visual estimation was >1,000 mL (n = 32) (R 2 = 0.035, correlation = 0.187) (p = 0.027). CONCLUSION: Implementation of a device that accurately measures blood loss allows for a better prediction of postoperative day 1 hemoglobin concentration than is possible using visual blood loss estimation. This improvement was seen in the entire patient group and was particularly prominent in patients with blood losses of > 1,000 mL. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Florian Piekarski; Lara Gerdessen; Elke Schmitt; Linda Tanner; Florian Wunderer; Vanessa Neef; Patrick Meybohm; Kai Zacharowski; Florian Jürgen Raimann Journal: PLoS One Date: 2020-10-21 Impact factor: 3.240