Farmakokinetski model i biometrijski parametri kod indirektnog određivanja gubitaka krvi tokom carskog reza

Abstract

<p>Cesarean section is one of the most commonly performed major operations in women throughout the world. Major obstetric hemorrhage is one of the leading death causes for women in generative period in the world; hence determination of blood loss during cesarean section is still an important issue. In addition, the volume of surgical blood loss is an important indicator of surgical quality. It influences aspects of clinical care such as blood transfusion, postoperative recovery, and potential complications. It is associated with the difficulty of surgery, as well. Blood loss during cesarean section was calculated based on post-operative decrement of hemoglobin (Hb) and hematocrit (Hct) level, using different methods: by Flordal, by Millar and by Stafford. These models used for pregnant women were previously validated for non-pregnant women who underwent gynecological surgery. One thousand and sixty-eight pregnant women who underwent cesarean section and five hundred and seventeen women who underwent gynecological surgery were included in the study. This study confirmed the applicability of existing models based on the drop in Hb and Hct levels for blood loss calculations for both gynecological surgery and cesarean section. Improved methods for calculating blood loss, V after cesarean section as V=0.0115 x body weight (kilograms) x ln (preoperative Hb/postoperative Hb) +0.1905 x height3 (meters) x ln (preoperative Hb /postoperative Hb) +0.3158 and after gynecological surgery V=0.004 x body weight (kilograms) x ln (preoperative Hb /postoperative Hb) + 0.4624 x height3 (meters) x ln (preoperative Hb /postoperative Hb) +0.0472 were suggested. Also, new biometric parameters for calculating blood volume in pregnant and non-pregnant women were recommended.</p>