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Rapid Prediction of Hematocrit Following Blood Loss and Fluid Shifts Using a Nomogram
Francesco M. Egro, MBChB, MSc, MRCS; Elizabeth M. Kenny, BS; Ernest C. Manders, MD; Ernest K. Manders, MD
University
2018-02-14
Presenter: Elizabeth Kenny
Affidavit:
Vu. T. Nguyen
Director Name: Vu. T. Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: There is often a need for a simple means of predicting hematocrit (Hct) – the volume of red blood cells (RBC) in the blood – following blood loss, administration of intravenous fluids, or fluid shifts without cumbersome calculation or costly clinical testing. This study aims to introduce a nomogram for rapid prediction of Hct in a number of common clinical scenarios.
Methods: Assuming a constant blood volume (BV) of 75 ml/kg, a nomogram for prediction of Hct was created using the following variables: 1) BV determined from body weight, 2) estimated blood loss, and 3) initial hematocrit.
Results: Two nomograms were generated for prediction of Hct after blood loss, administration of intravenous fluids, or fluid shifts in 1) neonates, infants, and children, and 2) adults. Using the nomogram, we demonstrated its utility in prediction of Hct after fluid or blood loss, fluid administration, or a combination of the two. The nomogram allows adjustment for measured and insensible fluid losses and fluid administration. Alternatively, fluid loss or blood loss can be back-calculated if Hct is known.
Conclusion: It is possible to use the in's and out's of fluid balance to calculate resultant Hct. A nomogram makes this task fast, simple, and cost-effective.
