Limitations of Gravimetric Quantitative Blood Loss during Cesarean Delivery.

 This study examined the accuracy, sources of error, and limitations of gravimetric quantification of blood loss (QBL) during cesarean delivery.  Blood loss determined by assays of the hemoglobin content on surgical sponges and in suction canisters was compared with QBL in 50 parturients.  QBL was moderately correlated to the actual blood loss (  = 0.

Automated Quantification of Blood Loss versus Visual Estimation in 274 Vaginal Deliveries.

Objective: The aim of the study is to compare quantified blood loss measurement (QBL) using an automated system (Triton QBL, Menlo Park, CA) with visual blood loss estimation (EBL) during vaginal delivery.

Study Design: During 274 vaginal deliveries, both QBL and EBL were determined. The automated system batch weighs blood containing sponges, towels, pads, and other supplies and automatically subtracts their dry weights and also the measured amount of amniotic fluid.

Accurate Assessment of Blood Loss during Cesarean Delivery Improves Estimation of Postoperative Hemoglobin.

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,  = 2,025) versus estimates using a mobile application that photographs sponges and canisters and calculates their hemoglobin content (device,  = 756).

Results: The correlation between the actual and predicted postoperative day 1 hemoglobin value (PPO1 Hgb) was better in the device group (  = 0.

How does blood loss relate to the extent of surgical wound excision?

Purpose: We investigated a novel system that uses image-processing algorithms to accurately measure the hemoglobin content of discarded surgical sponges to determine how blood loss relates to the excised area when current methods to minimize bleeding are employed. The system was used during 130 procedures in adult patients having wound excisions  ≥1% BSA (study group). An historic group of 105 similar cases in whom visually estimated blood was determined was also evaluated.

Clinical Experience with the Implementation of Accurate Measurement of Blood Loss during Cesarean Delivery: Influences on Hemorrhage Recognition and Allogeneic Transfusion.

Objective: This article compares hemorrhage recognition and transfusion using accurate, contemporaneous blood loss measurement versus visual estimation during cesarean deliveries.

Study Design: A retrospective cohort study using visually estimated blood loss (traditional,  = 2,025) versus estimates using a mobile application that photographs sponges and canisters and calculates their hemoglobin content (device,  = 756).

Results: Blood loss > 1,000 mL was recognized in 1.

Accuracy of Blood Loss Measurement during Cesarean Delivery.

 This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard.  In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland-Altman method.

Use of Thromboelastography (TEG) for Detection of New Oral Anticoagulants.

Context: The clinical introduction of new oral anticoagulants (NOACs) has stimulated the development of tests to quantify the effects of these drugs and manage complications associated with their use. Until recently, the only treatment choices for the prevention of venous thromboembolism in orthopedic surgical patients, as well as for stroke and systemic embolism in patients with atrial fibrillation, were vitamin K antagonists, antiplatelet drugs, and unfractionated and low-molecular-weight heparins. With the approval of NOACs, treatment options and consequent diagnostic challenges have expanded.

Implementation of a comprehensive blood conservation program can reduce blood use in a community cardiac surgery program.

Objective: The study objective was to determine the effects of implementing a blood conservation algorithm on blood product use and outcomes in a community cardiac surgery program.

Methods: A blood management strategy including lower hemoglobin transfusion threshold and algorithm-driven decisions was adopted. Intraoperatively, point-of-care testing was used to avoid inappropriate component transfusion.

The thymus: a comprehensive review.

Since first being described as such by Galen of Pergamum (130-200 ad), the thymus has remained an "organ of mystery" throughout the 2000-year history of medicine. The thymus reaches its maximum weight in puberty and subsequently undergoes involution, and thus is hardly an eye-catching structure on imaging studies performed in healthy adults. However, once there has been involvement of the thymus by a disease process, the gland demonstrates a variety of clinical and radiologic manifestations that require comprehensive understanding of each entity.

Microdebrider bronchoscopy: a new tool for the interventional bronchoscopist.

Purpose: We report our experience with a new airway tool, the microdebrider, in treating central airway obstruction.

Description: From April 2002 to April 2004, 23 patients undergoing treatment of central airway obstruction were managed with the microdebrider. All procedures were done under general anesthesia with either a rigid bronchoscope (19 patients) or a suspension laryngoscope (4 patients).

Mediastinal and chest wall limitations to asymmetry of lung inflation.

The extent to which inflation of one lung increases pleural pressure around the contralateral lung could affect ventilatory function, e.g., after pneumonectomy or lung transplantation.