Changes in blood volume during major surgery were studied in 37 patients. In each, the blood volume was determined first after induction of anesthesia and again after closure of the skin incision. The method depended on the intravenous injection of a precisely measured amount of radioiodinated serum albumin and the determination of the resultant intensity of radioactivity in the circulating blood. The reliability of the method was determined by a test-retest procedure in three volunteer subjects. The results, corrected to take into account the blood given by transfusion during the operations, showed that major orthopedic surgery involves significant loss of blood. Transfusions were given to 32 patients, and among these there were 5 in whom the deficit of blood would have amounted to more than 1,000 cc., had they not received transfusions. The use of radioactive elements to measure blood volume helps in estimating transfusion needs.
Powers WF, Hensley CD. CIRCULATING BLOOD VOLUME CHANGES INCIDENT TO MAJOR ORTHOPEDIC SURGERY. JAMA. 1959;169(6):545–547. doi:10.1001/jama.1959.03000230001001
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