Wael Awada
Al-Ghad International College of applied science, Saudi Arabia
Title: Case study of bilateral hip replacement evaluation of continous
Biography
Biography: Wael Awada
Abstract
Introduction: Hemorrhage is a medical emergent that is frequently encountered in emergency - operating rooms and intensive care units. Significant loss of intravascular volume may lead sequentially to hemodynamic instability, cellular hypoxia, organ damage, and death.
Presentation of Case Report: Fifty four (54) years of male patient had spinal fracture with paraplegia, bilateral hip, knee stiffness and programmed for bilateral hip replacement. Intraoperatively we used continuous spectrophotometry (SpHb) and pleth variability index (PVi) monitoring by ADC blood gases obtained to compare SpHb & true hemoglobin (tHb) from CO-oximetry. We confronted severe intra operative uncontrollable bleeding during dissection of the right hip joint. Blood units despite that was reserved pre-operative they were not available perioperative. The total blood loss was 3400 cc, patient was hooked up to a drip administer intravenous fluids (colloids and crystalloids), no inotropic support was needed. The target was patient’s blood pressure to be kept hemodynamically at low level 110_80 systolic and 60_40 diastolic with maintained mean ABP 65-50 mm Hg. Patient was transferred to ICU where he received 6 units blood, 6 units plasma, 2 vial fibrinogen, 4 units cryo ppt and he was extubated fully conscious and vitally stable after four hours.
Conclusion: Noninvasive and continuous Hb measurement could offer accepted range of accuracy for hemoglobin level especially with low hemoglobin levels and its impact on blood transfusion management. The specific case was tider for a series of publications in valid medical journals about noninvasive hemoglobin monitoring.