TYK369

A 3 year-old, 12 kg, previously healthy boy is brought to the operating room after sustaining multiple non-accidental traumatic injuries to the abdomen. The initial FAST exam was concerning for two large fluid collections adjacent to the liver and spleen; the patient is brought to the OR for exploratory laparotomy. Crystalloid resuscitation is initiated and the patient is restored to euvolemic status. At this time, the hemoglobin value is 9 mg/dL. Immediately after induction of anesthesia the hemoglobin is rechecked and is now 4 mg/dL. Assuming the patient’s volume status (preload) is unchanged, how much blood loss has occurred between the time the first hemoglobin value was obtained and now?

a) 100 mL

b) 200 mL

c) 300 mL

d) 400 mL

e) 500 mL

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Answer

Answer e. Utilizing the MABL formula, we can back-calculate the result (see text): (75 mL/kg x 12 kg ) x ( 9 mg/dL – 4 mg/dL) = 4500. 4500 / 9 = 500 mL estimated blood loss.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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