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Successful Management of Massive Blood Loss to Extremely Low Hemoglobin in an Elderly Woman Receiving Spinal Surgery

老年婦女因脊椎手術後大量失血導致極低血紅素之處理

摘要


當急性大量失血導致血色素低於6g/dL時就需要輸血急救,然而困擾麻醉醫師的是有些時候并無法馬上取得血液來救治病患。在此病例報告中,我們描述一位81歲的女性病患,因脊椎骨手術後意外的急性大量失血尊導血紅素低至1.4g/dL。在等候市區血庫配血及運送期間,我們僅藉給予輸液及腎上腺素來維持心輸出量。病患於術後三天內完全復元且無任何後遺症以生。

並列摘要


Blood transfusion is absolutely indicated in acute anemia when the hemoglobin concentration falls below 6g/dL. Sometimes it challenges the anesthesiologists lithe blood intended for urgent transfusion is not readily or quickly available. In this case report, we describe an 81-year-old lady who accidentally sustained acute anemia after spinal surgery with the hemoglobin concentration falling to 1.4g/dL. During the long wait for the process of cross-matching tests and delivery of blood from the blood bank in the city remote from the hospital, we could do nothing but administer crystalloid and colloid solutions to maintain the circulatory volume to prevent low cardiac output. Epinephrine was given when systolic blood pressure fell below 70 mmHg. Central venous pressure and arterial blood pressure were monitored to guide all the treatment. Fortunately, patient fully recovered on postoperative day 3 without any adverse events.

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