Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass
Bleeding is a common problem during resection of a retroperitoneal mass. Massive bleeding may occur in case of injury of an adjacent major vessel or organ. This case report describes a successful anesthetic management of a patient with 10 l of blood loss within three hours surgery. A 44-year-old wom...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2015-04-01
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| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110184915000057 |
| _version_ | 1818970140461498368 |
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| author | Xueqin Zhu Yu Gui Binbin Zhu Jian Sun |
| author_facet | Xueqin Zhu Yu Gui Binbin Zhu Jian Sun |
| author_sort | Xueqin Zhu |
| collection | DOAJ |
| description | Bleeding is a common problem during resection of a retroperitoneal mass. Massive bleeding may occur in case of injury of an adjacent major vessel or organ. This case report describes a successful anesthetic management of a patient with 10 l of blood loss within three hours surgery. A 44-year-old woman who underwent an operation for resection of a retroperitoneal mass, went to a hypovolemic shock, due to acute life-threatening intra-operative bleeding, and was successfully rescued with a combination of measures, including control of surgical bleeding, supportive treatment with rapid fluid infusion, massive transfusion of blood products and administration of intravenous vasoactive agents for maintaining tissue perfusion and oxygenation, utilizing intraoperative autologous blood salvaged via cell saver, as well as prevention and treatment of complications. The patient received a total of 22 units of Packet Red Blood Cells (PRBCs), 18 units of Fresh Frozen Plasma (FFP), 10 units of cryoprecipitate, 3750 ml of her own salvage blood. Postoperatively, she was transferred to the intensive care unit (ICU) with mechanical ventilator support, where she received another 5.4 units of FFP, 10 units of cryoprecipitate. The patient developed features of early acute lung injury such as fever and hypoxemia, and was managed successfully with mechanical ventilator support for a few days. At a three-month follow-up, the patient was doing very well. This paper explores the pathogenesia, implications, prevention and treatment of the transfusion-associated complications such as acidosis, hypothermia, electrolyte abnormalities, and transfusion-related acute lung injury (TRALI). Particular attention is given to the prevention of secondary coagulopathy of the patient requiring massive blood transfusion. This case study presents a good reference for similar anesthetic scenario in the future. |
| first_indexed | 2024-12-20T14:31:45Z |
| format | Article |
| id | doaj.art-63dd47b105554e4395d6659c7d088b2f |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-20T14:31:45Z |
| publishDate | 2015-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-63dd47b105554e4395d6659c7d088b2f2022-12-21T19:37:35ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492015-04-0131220721310.1016/j.egja.2015.01.003Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal massXueqin ZhuYu GuiBinbin ZhuJian SunBleeding is a common problem during resection of a retroperitoneal mass. Massive bleeding may occur in case of injury of an adjacent major vessel or organ. This case report describes a successful anesthetic management of a patient with 10 l of blood loss within three hours surgery. A 44-year-old woman who underwent an operation for resection of a retroperitoneal mass, went to a hypovolemic shock, due to acute life-threatening intra-operative bleeding, and was successfully rescued with a combination of measures, including control of surgical bleeding, supportive treatment with rapid fluid infusion, massive transfusion of blood products and administration of intravenous vasoactive agents for maintaining tissue perfusion and oxygenation, utilizing intraoperative autologous blood salvaged via cell saver, as well as prevention and treatment of complications. The patient received a total of 22 units of Packet Red Blood Cells (PRBCs), 18 units of Fresh Frozen Plasma (FFP), 10 units of cryoprecipitate, 3750 ml of her own salvage blood. Postoperatively, she was transferred to the intensive care unit (ICU) with mechanical ventilator support, where she received another 5.4 units of FFP, 10 units of cryoprecipitate. The patient developed features of early acute lung injury such as fever and hypoxemia, and was managed successfully with mechanical ventilator support for a few days. At a three-month follow-up, the patient was doing very well. This paper explores the pathogenesia, implications, prevention and treatment of the transfusion-associated complications such as acidosis, hypothermia, electrolyte abnormalities, and transfusion-related acute lung injury (TRALI). Particular attention is given to the prevention of secondary coagulopathy of the patient requiring massive blood transfusion. This case study presents a good reference for similar anesthetic scenario in the future.http://www.sciencedirect.com/science/article/pii/S1110184915000057Massive transfusionCoagulopathyHypokalemiaRetroperitoneal mass |
| spellingShingle | Xueqin Zhu Yu Gui Binbin Zhu Jian Sun Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass Egyptian Journal of Anaesthesia Massive transfusion Coagulopathy Hypokalemia Retroperitoneal mass |
| title | Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| title_full | Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| title_fullStr | Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| title_full_unstemmed | Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| title_short | Anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| title_sort | anesthetic management of a patient with 10 l of blood loss during operation for a retroperitoneal mass |
| topic | Massive transfusion Coagulopathy Hypokalemia Retroperitoneal mass |
| url | http://www.sciencedirect.com/science/article/pii/S1110184915000057 |
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