Anesthetic management of a patient with 10l of blood loss during operation for a retroperitoneal mass

Publication date: Available online 11 February 2015 Source:Egyptian Journal of Anaesthesia Author(s): Xueqin Zhu , Yu Gui , Binbin Zhu , Jian Sun 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 10l 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, 3750ml 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 mec...
Source: Egyptian Journal of Anaesthesia - Category: Anesthesiology Source Type: research