title: [Therapy of acute massive blood loss in a hemophilic patient: case report].
abstract: 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.
authors.forename: A Iu
authors.initials: AIu
authors.lastname: Bulanov
authors.forename: E M
authors.initials: EM
authors.lastname: Shulutko
authors.forename: E E
authors.initials: EE
authors.lastname: Karpov
authors.forename: T Iu
authors.initials: TIu
authors.lastname: Polianskaia
authors.forename: G V
authors.initials: GV
authors.lastname: Mishin
authors.forename: S A
authors.initials: SA
authors.lastname: Morozov
authors.forename: N N
authors.initials: NN
authors.lastname: Kalinin
authors.forename: A V
authors.initials: AV
authors.lastname: Tochenov
authors.forename: K V
authors.initials: KV
authors.lastname: Iatskov
authors.forename: V Iu
authors.initials: VIu
authors.lastname: Zorenko
authors.forename: M S
authors.initials: MS
authors.lastname: Sampiev
mesh_terms: D000208:Acute Disease; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000379:methods*; D001810:Blood Volume; D005593:Fracture Fixation, Internal; D006406:Hematoma / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006438:Hemodilution / Q000379:methods*; D006467:Hemophilia A / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D006620:Hip Fractures / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes