Reliability of Visually Estimated Blood Loss with Hemoglobin Measurement: 200 Cases of Craniosynostosis Surgery


Anesthesiologist, Anesthesiology Research Center (ARC), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.


Bleeding is one of the most common complications of craniosynostosis surgery, which its appropriate management is associated with better post-operative outcomes. The aim of this retrospective study was to evaluate the visual estimated blood loss in intraoperative management of infants with craniosynostosis surgery.
Materials and Methods
This retrospective study was performed on 200 patients who underwent craniocinostosis surgery and hospitalized in intensive care unit (ICU) at Mofid Hospital, Tehran, Iran, from July 2015 to June 2017. Data collecting was done using a self-made checklist and from patients' medical record. Required data include age, gender, method of anesthesia, and arterial blood gas (ABG), hemoglobin (Hb), and platelet (Plt) changes during surgery, volume of administered blood and fluid were recorded and evaluated. Data analysis using SPSS software (version 22.0).
Among the patients, 59% (n=118) were boys, the mean age of patients was 13.3 ± 13.52 months. Anesthesia technics were total intravenous anesthesia (TIVA) (15.5%, n= 31), and inhalation or mixed (84.5%, n=169). Patients received 992.02 ± 468 ml fluid and 205.86± 100 ml blood, before surgery.There was no significant difference between preoperative Hb and first Hb in pediatric intensive care unit (PICU) (p=0.12). However, preoperative and first Plt in PICU were different (p=0.000). Also, last Hb in ABG (10.5±1.90), and the first Hb in PICU showed no significant difference (r=0.088, p=0.219).
According the results, visual assessment and correction of blood loss with hemoglobin measurement and by experienced anesthesiologist was a reliable and safe method in patients with craniosynostosis surgery and feasible in every operating room.