BLOOD LOSS DURING PEDIATRIC OPERATIONS.

The gravimetric method of measuring blood loss was used during all types of pediatric operations at The Montreal Children's Hospital. Results of 1787 such measurements indicated that the method is of value in the management of transfusion. Grading blood loss as minor, moderate or severe, in terms of its relation to total blood volume or body weight is a procedure of practical value. Operations were grouped into those that usually led to a loss of less than 10% of the blood volume (7.5 ml./kg.), those with a loss usually between 10% and 14% and those with blood loss usually over 14% (10.5 ml./kg.), in order that appropriate plans for transfusion could be made to reduce the incidence of serious hypovolemia without fear of cardiovascular overloading. Blood loss at operation (adenotonsillectomy) was noted to vary considerably among surgeons but was fairly constant for each surgeon and seemed to be independent of the surgeon's experience. Two alleged hemostatic agents, adrenochrome carbazone (Statimo) and estrogenic substances (Premarin), were not effective in reducing the amount of blood lost during adenotonsillectomy. The importance of calculation of approximate equivalent amounts of blood at various ages of childhood is emphasized.