MATHEMATICAL MODELS OF BLOOD LOSS PREDICTION IN IDIOPATHIC SCOLIOSIS SURGERY
Aim of the study: to develop mathematical models of prediction of intraoperative blood loss in scheduling of scoliosis surgical correction and to prove their applicability in clinical practice. Material and methods. The analysis of intraoperative hemorrhage severity level in the course of surgical treatment of 395 patients with idiopathic scoliosis has been carried out. The factors significantly affecting the size of intraoperative blood loss were analyzed: duration of surgical intervention, the number of the executed TPF levels, rising of intra abdominal pressure. Results. It has been shown that use of patient prone intraoperative positioning with control of full decompression of arterial obdominal wall has allowed avoiding effect of increase in intra belly pressure, minimizing severity of intraoperative venous bleeding that has led to decrease in blood loss by 60,0 %. Confirmation to it is the fact that intraoperative blood loss in 50,9 % of patients did not exceed 15 % of circulating blood volume, the volume of intraoperative blood loss in 33,7 % of patients was in the range from 15 to 30 % of circulating blood volume. That has allowed not to carry out a hemotransfusion with use of donor blood components in 75,9 % of operated patients and thereby to reduce the real risk of haemotransfusion complications. Mathematical models of blood loss forecasting for dorsal spondylosyndesis operations with the TPF equipment use have been developed on the basis of the revealed mechanisms by carrying out the regression analysis. Conclusion. Full decompression of arterial obdominal wall of patients is blood saving approach in spine surgery carrying out in patient prone intraoperative positioning. Use of mathematical models of blood loss prediction can be an effective measure of perioperative blood saving technologies optimization in scoliosis surgery on the basis of the personified approach to forecasting and prophylaxis of hemorrhagic syndrome development.
About Authors (Correspondence):
Lebedeva M.N. – doctor of medical sciences, deputy chief physician for anesthesiology providing, chief researcher of the anesthesiology and emergency medicine department, e-mail: MLebedeva@niito.ru