A practical method for determining the amount of blood passing over during direct transfusion / E. Libman and R. Ottenberg.

  • Libman, Emanuel, 1872-1946.
Date:
1914
Catalogue details

Licence: In copyright

Credit: A practical method for determining the amount of blood passing over during direct transfusion / E. Libman and R. Ottenberg. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ycatteml warnings in the literature as to the danger of acute dilatation of the patient's heart from excessive transfusion led us, at first, to make a similar calculation as to the amount of blood M'hich a given patient could receive. Experience, however, in over one hundred trans- fusions has shown that this is necessary only when there is a disparity between the size of patient and donor, as in the transfusion of children or small adults. Usually the circulation adjusts itself rapidly and easily to the increase of blood volume, and it is practically impossible (except in the preceding instances) for a donor, without collapsing to give up enough blood to embarrass seriously the circulation of an adult recipient. In fact, in both donor and patient, circulatory embarra.ssment resulting from transfusion appears to depend on the speed with which the blood is transfused rather than the amount transfused; and by transfusing slowly it is generally possible to avoid any unfavorable symptoms on the ]iart of either. In over 1.30 lransfusion.«,- during which we were able to control the amount to be transfused, we saw no instance of any circulatory embarrassment. But we know of a number of other instances in which this did occur. We have records of two of these. I'he one was a ca.se of subacute bacterial endocarditis resulting in death a few hours after the transfusion and showing, post mortem, numerous infarctions in the heart-muscle. The other was a case in which an unjustifiably larcfe tran.s- fusion was followed by edema of the lungs and hema- turia lasting two days. This was the type of case in which trouble could have been easilv avoided if a calcu- lation had been made, as there was great discrepanev in the sizes of donor and patient. The donor weighed 190 pounds and had 95 per cent, of hemoglobin. The patient weighed 97 pounds and her hemoglobin was 15 per cent. Calculation shows that if 2^/2 pounds of blood (equivalent to one-quarter of the donor’s or one-half of the patient’s blood volume) had been transfused the hemoglobin would have been rai.sed to .31 per cent. Instead it was raised in twenty minutes to 52 per cent, (indicating that over 4 pounds of blood had been trans- fused*). 2. IVrformpd b.v the vnrlous siirseons on the stnfT of the Mount Slniii Ilosniliil.