Терапевтический архив (Aug 2011)

Therapy of acute massive blood loss in a hemophiliac male: case report

  • Andrey Yul'evich Bulanov,
  • Elena Markovna Shulutko,
  • Evgeniy Evgen'evich Karpov,
  • Tat'yana Yur'evna Polyanskaya,
  • Georgiy Vladimirovich Mishin,
  • Sergey Aleksandrovich Morozov,
  • Nikolay Nikolaevich Kalinin,
  • Aleksandr Vladimirovich Tochenov,
  • Konstantin Vladimirovich Yatskov,
  • Vladimir Yur'evich Zorenko,
  • Magomed Sultanovich Sampiev,
  • A Yu Bulanov,
  • E M Shulutko,
  • E E Karpov,
  • T Yu Polyanskaya,
  • G V Mishin,
  • S A Morozov,
  • N N Kalinin,
  • A V Tochenov,
  • K V Yatskov,
  • V Yu Zorenko,
  • M S Sampiev

Journal volume & issue
Vol. 83, no. 8
pp. 70 – 73

Abstract

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A case is reported of management of massive intraoperative blood loss in a male patient with severe hemophilia. Extirpation of hip pseudotumor with one-stage osteosynthesis with an intramedullary joint-pin in a 43 year old male patient was accompanied with 7.5 l blood loss. The infusion-transfusion therapy (ITT) contained transfusion media about 1/3 of the total volume, fresh-frozen plasma and erythrocyte-containing media were used 1:1. Infusion solutions consisted of balanced polyelectrolytic solutions, hydroxyethylated starches 130/0.4, hyperchaes. Intraoperative normovolemic hemodilution and reinfusion of wound blood were made (CellSaver). ITT target markers were standard hemodynamics control tests. Hemostasis monitoring was conducted with thromboelastography. Complex ITT based on modern principles of clinical transfusiology provided a complete and safe compensation of massive intraoperative blood loss in a patient with severe hemophilia.

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