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E-pub ahead of print

Measurements of cardiac output and management of blood transfusions during burn surgery - an observational prospective study

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PURPOSE: Burn surgery can cause extensive bleeding which lead to perioperative blood transfusions. The purpose of this study was to investigate, whether blood transfusions during burn surgery, guided by standard monitoring with inspection of the operative field, measurements of blood pressure, heart rate, hourly diuresis, and concentrations of hemoglobin and lactate could sustain the preoperative cardiac output (CO) till end of surgery.

METHOD: We investigated 15 patients ≥ 18 years of age scheduled for burn surgery, where the perioperative monitoring included an arterial line. After induction of anesthesia and before start of surgery, we measured baseline values of CO with the minimally invasive LiDCOrapid, mean arterial pressure (MAP), and concentrations of hemoglobin and lactate in arterial blood. We measured these values every 30 minutes through surgery. The primary outcome was change in CO from baseline till end of surgery. Secondary outcomes included the change in concentrations of hemoglobin and lactate from baseline till end of surgery.

RESULTS: We found no statistically significant change in CO from baseline till end of surgery (6.6 (±2.4) L/min; 7.2 (±3.2) L/min; p=0.26). We found a statistically significant decrease in concentration of hemoglobin (7.2 (±0.8) mmol/L; 6.2 (±0.9) mmol/L; p=0.0002), and a statistically significant increase in concentration of lactate (1.3 (±0.5) mmol/L; 1.7 (±1) mmol/L.; p=0.02).

CONCLUSION: The perioperative blood transfusion guided by standard monitoring seemed to sustain CO from baseline till end of surgery, however, further research is needed to confirm this.

OriginalsprogEngelsk
TidsskriftJournal of burn care & research : official publication of the American Burn Association
ISSN1559-047X
DOI
StatusE-pub ahead of print - 6 okt. 2020

Bibliografisk note

© The Author(s) 2020. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

ID: 60977504