Evaluation of the effectiveness of empirical and computational methods for determining volumes of blood loss in the surgical treatment of burned patients

Abstract

Relevance. The problem of determining intraoperative blood loss in combustiology remains relevant today. With the variety of existing methods of its assessment, the issue of optimizing transfusion therapy remains debatable. Intention. To evaluate effects of the eschar excision area on the complete blood count and to compare results of computational methods for determining volumes of blood loss with actual volumes of blood exfusion. Methodology. 73 burned patients were included in the retrospective study. Early surgical excision with simultaneous autodermoplasty was performed in all patients. To achieve the study purposes, the intervention areas were compared with changes in hemoglobin, hematocrit, volume and number of red blood cells. The prospective study included 20 volunteers who donated 450 ml of the whole blood. In this group, donated volumes were compared with calculated volumes of blood loss (according to PG. Budny and G.D. Warden). The data obtained were processed via Microsoft Office Excel 2007 and IBM SPSS Statistics 20.0 using descriptive, parametric and nonparametric statistics. Results and Discussion. According to the retrospective analysis, actual areas of excision were not consistently related to the changes in complete blood count in the postoperative period. Based on the results of prospective analysis, we were able to reveal correlations between actual volumes of blood loss and changes in hemoglobin concentrations in somatically healthy volunteers (by PG. Budny). There were no similar correlations between volumes of blood loss and decreased hematocrit (by G.D. Warden). Conclusion. According to the results of the study, we couldn't confirm the effectiveness of empirical methods for determining volumes of blood loss in burned patients. The PG. Budny formula gives representative results of blood loss volumes in healthy volunteers. However, the effectiveness of this method in combustiology requires further research.