Accuracy of Visual Estimation of Intraoperative Blood Loss compared to calculated blood loss and factor which affect it In Adult Patients on elective surgical patients at Tikur Anbesa Specialized teaching Hospital (TASH), Addis Ababa, Ethiopia, 2023/24.

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Date

2024-05

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Addis Ababa University

Abstract

Background: -Visual estimation of blood loss has been the most commonly used method and sometimes, the only method available for assessing intraoperative blood loss simply because it is easy, quick, and convenient. Accurate assessment of intraoperative blood loss is an important aspect of perioperative management of patients undergoing surgery where blood loss is often dispersed. Under estimation of bleeding can pose a danger to the patient’s recovery and sometimes also it can be a threat to life, especially when associated with hemodynamic instability (6-7).Over estimation of bleeding can lead to unnecessary blood transfusion, exposes the patient to needless risks such as infections, hemolytic and non hemolytic transfusion reactions(13).Improving visual estimation of blood loss is crucial step in management of surgical patients and decision of transfusing a patient should not always depend on estimation . Objective: - to asses accuracy Of visual estimation of intraoperative blood loss compared to calculated blood loss in adult patients on elective surgical patients at Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia, 2023/24. Method: -institutional based prospective cross-sectional study was used from Jan to march 2024 the study was conducted in TASH on 243 patients .Data was collected by modified questionnaire. Data collection was done by anesthesiology resident, anesthetists and medical interns. Simple convenient sampling technique was used as sampling technique. Data was checked for completeness and data was entered cleaned and analyzed by SPSS 27.00 version statistical software. Descriptive analysis was done for socio-demographic values. The absolute mean error was also compared .and factors that affect the accuracy of VEBL was assessed by multiple regression Result: visual estimation of blood loss is in accurate by average of 29.1 % from calculated blood loss .21.8 %( Anesthesia side) and 36.4 % (surgical side) among the factors amount of bleeding also had its own impact by ;for those bleeding < 500 ml absolute mean error is 136 ml ,for 501- 1000ml absolute mean error is 145, for 1001-1500 ml absolute mean error is 297 for 1501-2000 ml absolute mean error is 265 and for those >2000 ml absolute mean error is 471 ml Key word VEBL Conclusion Visual estimation of blood loss is inaccurate and subjective. Both anesthesiologists and the surgical side underestimated based on visual estimation. However, anesthesiologists generally outperformed surgical teams in visually with their estimates being closer to the actual blood loss that was calculated blood loss from pre- and post-operative hematocrit values

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Keywords

Blood loss, Complete blood loss, Estimated Blood Loss, Hemoglobin

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