Blood loss during vascular access cannulation: Quantification using the weighed gauze and drape method

Abstract

Anemia is an important complication of chronic renal disease, with a significant impact on the morbidity, quality of life, and mortality in this group of patients. Inadequate erythropoietin production, reduced life span of erythrocytes in uremic serum, bone marrow suppression by uremic toxins, chronic inflammation, and contaminants in the water treatment unit are recognized etiological causes of anemia in chronic kidney disease patients. Little attention has been paid to possible contributions of small but continual loss of blood during vascular access cannulation for hemodialysis in these patients. The aim of this study is to quantify the volume of blood loss during femoral vein cannulation in patients on hemodialysis. The average volume of blood loss during femoral cannulation was evaluated using a simple and inexpensive procedure of deriving volume of blood lost, from the weights of soaked gauze and drape during the access cannulation procedure. The mean blood loss per procedure during femoral cannulation was 36.52 mL+/-2.70 SD, with a range of 6.47 to 100.20 mL. The calculated average weekly loss in patients on thrice-weekly dialysis schedule is 109.56 mL of blood, with a monthly loss of 438.24 mL. Cumulative blood loss during femoral vein cannulation appears to be significant. Its contribution in the sustenance of anemia in hemodialysis patients deserves further evaluation.

A Prospective Randomized Study Comparing Mini-surgical Percutaneous Dilatational Tracheostomy With Surgical and Classical Percutaneous Tracheostomy

“…Since it has been proved that physicians, especially the surgeons, underestimate the amount of blood loss during invasive procedures, we applied the gauze weight quantification method to calculate the actual blood loss during the procedures. 8 , 9 Mild (≤2 cc), moderate (2–5 cc), and severe (≥5 cc) bleeding was also defined. Hypoxemia was considered as arterial O 2 saturation (SaO 2 ) ≤90% in patients who were not on hypoxemic state before the procedures.…”

Increased Blood Loss From Access Cannulation Site During Hemodialysis Is Associated With Anemia and Arteriovenous Graft Use

“…The definition of hemostasis time was the time between disconnection from dialysis machine to when the bleeding completely stopped. The total amount of blood lost during the whole HD session was measured carefully by the gauze weight method . All the gauzes used for the cannulation site bleeding during each HD session and post‐HD hemostasis were carefully weighed by an electronic weighing scale.…”

Evaluation of Post-Puncture Bleeding Time of Arteriovenous Fistulas with IRIS® Bandage

“…A long delay significantly impacts the patient's quality of life by extending time to discharge, increases nursing workload, consumes valuable staff time usually dedicated to monitoring patient treatments and is likely to disturb the overall dialysis schedule organization of the hemodialysis unit. In addition, excessive post-dialysis puncture site bleeding estimated by the gauze weigh method has been recently found to be significantly associated with lower hemoglobin levels in an observational study ( 2 , 3 ). Conversely, excessive compression, especially with the use of hemostatic devices such as straps, tourniquets and rigid clamps, may damage vascular access walls and has been claimed by some authors to favor late fistula thrombosis ( 4 ).…”